Building page for web ce - Glenn-Colusa Irrigation District

Job Application

"*" indicates required fields

Step 1 of 6

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Position(s) Applied for*

Date Submitted*

MM slash DD slash YYYY

How did you hear about this opening?*

Employment Agency

Friend

Relative

Walk-In

Other

If other, please describe

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone

Mobile Phone

Email*

If you are under 18 years of age, can you provide required proof of your eligibility to work?*

Yes

Have you been employed with us before?*

Yes

If yes, give date:

MM slash DD slash YYYY

Have you ever filed an application with us before?*

Yes

If yes, give date:

MM slash DD slash YYYY

May we contact your current employer?*

Yes

Desired Salary*

Are you prevented from lawfully becoming employed in this country because of visa or immigration status? (Proof of citizenship or immigration status will be required upon employment.)*

Yes

On what date will you be available to work?

MM slash DD slash YYYY

Are you currently available to work?*

Are you currently on "lay-off" status and subject to recall?*

Yes

Are you willing to travel if a job requires it?*

Yes

List any special job-related skills and qualifications acquired from employment or other experience.*

Are you able to perform the tasks described on the job description, with or without accommodation?*

Yes

Please list any accommodations that may be necessary:

Education 1

Education Type

School name, location and phone number

Years completed

Describe course of study

Describe any specialized training, apprenticeship, skills and extracurricular activities

Describe any honors you have received

State any additional information you feel may be helpful to us in considering your application

Education 2

Education Type

School name, location and phone number

Years completed

Describe course of study

Describe any specialized training, apprenticeship, skills and extracurricular activities

Describe any honors you have received

State any additional information you feel may be helpful to us in considering your application

Education 3

Education Type

School name, location and phone number

Years completed

Describe course of study

Describe any specialized training, apprenticeship, skills and extracurricular activities

Describe any honors you have received

State any additional information you feel may be helpful to us in considering your application

Language 1

Language

Speaking

Reading

Writing

Language 2

Language

Speaking

Reading

Writing

Language 3

Language

Speaking

Reading

Writing

Start with your present or last job

Employer Experience 1

Employer Name

Address

From

MM slash DD slash YYYY

Phone

Supervisor

Job Title

Work Performed

Reason for Leaving

May we contact this employer?

Yes

Employer Experience 2

Employer Name

Address

From

MM slash DD slash YYYY

Phone

Supervisor

Job Title

Work Performed

Reason for Leaving

May we contact this employer?

Yes

Employer Experience 3

Employer Name

Address

From

MM slash DD slash YYYY

Phone

Supervisor

Job Title

Work Performed

Reason for Leaving

May we contact this employer?

Yes

References

Reference 1

Name

Address

Phone

Reference 2

Name

Address

Phone

Reference 3

Name

Address

Phone

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand and acknowledge that the policy of Glenn-Colusa Irrigation District is such that the existence of a criminal conviction will not necessarily disqualify my application for employment. I understand that if offered employment, the offer may be contingent on passing a pre-employment alcohol and drug screen and pre-employment physical and voluntarily agree to submit to these procedures. I also understand that I will be required to submit proof of my identity and legal right to work in the United States prior to my first day of employment. If the position applied for requires driving in the course of work, I understand that I will be required to possess a current and valid California driver’s license and understand that I will be required to provide a copy of my official driving record and proof of insurance. This application for employment shall be considered active for a period of time not to exceed six (6) months. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of Glenn-Colusa Irrigation District, a copy of which will be provided to me at the time that I begin employment. Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by Glenn-Colusa Irrigation District, I am entitled to copies of any such records obtained, unless I check the box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.

Consent

I waive receipt of a copy of any public record described in the paragraph above.

Signature*

Date*

MM slash DD slash YYYY

Notes

Attach your resume and cover letter here (must be in .pdf, .doc or .docx format).

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 256 MB.