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City of Stanwood Job Application-ADM
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Steps
1.
Step One
This section is complete
This section is incomplete
2.
Personal Information
This section is complete
This section is incomplete
3.
Position Information
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4.
Employment History
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5.
Education
This section is complete
This section is incomplete
6.
Professional References
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This section is incomplete
7.
Other
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This section is incomplete
8.
Disclaimer, Waiver and Signature
This section is complete
This section is incomplete
9.
Authorization to Release Information
This section is complete
This section is incomplete
10.
Voluntary Affirmative Action Data
This section is complete
This section is incomplete
Step One
Job Application
The City of Stanwood does not accept unsolicited resumes or application packets for positions that are not currently listed or advertised. An application, completed in its entirety, must be submitted in order for you to be considered for an open position.
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Personal Information
First Name
*
Middle Initial
*
Last Name
*
Street Address
*
City and State
*
Zip
*
Have you resided at the above address at least 3 years? If no give previous address below.
Previous Address
City and State
Zip
Phone Number
*
Email Address
*
Are you legally eligible for employment in the United States?
*
Yes
No
Do you possess, or can you obtain, a valid Washington State Driver's License?
*
Yes
No
Are you 18 years or older?
*
Yes
No
If under 18 years of age, can you furnish a work permit?
Yes
No
Are you available for full-time employment? If not, please indicate your availability below.
*
Yes
No
I am available to work the following schedule:
You may need to work overtime. Will such a requirement create a problem for you?
*
Yes
No
Have you ever applied for employment with the City of Stanwood?
*
Yes
No
If yes, Month and Year
Department
Do you have relatives working for the City of Stanwood?
*
Yes
No
If yes, who?
Have you ever worked for, or are you acquainted with other City of Stanwood employees?
*
Yes
No
If yes, who?
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Position Information
Which open position are you applying for?
*
How did you hear about this position?
*
Describe your abilities, knowledge and skills that qualify your for this position:
*
List your licenses or certificates (professional or trade licenses or certificates required for this position)
*
Upload your Resume
Upload your Cover Letter
Upload Supplemental Questions
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Employment History
Beginning with your present or most recent employment, list your employment history for the last ten (10) years. Please complete the following sections even if you are submitting a resume in addition to the application. An incomplete application may disqualify you. If you have been known by a different name by any of the following employers or educational institutions, please identify the employer/educational institution and state the name below:
(From Most Recent)
Employer's Name
Position Title
Supervisor
Phone Number
Address
Name known by if different than above
Hours worked per week
Number of employees supervised by you
May we contact this employer?
Yes
No
If no, please state reason
Responsibilities
Employed From - To (Date)
Reason for leaving (if still employed, indicate reason for wanting to leave).
Employer's Name
Position Title
Supervisor
Phone Number
Address
Name known by if different than above
Hours worked per week
Number of employees supervised by you
May we contact this employer?
Yes
No
If no, please state reason
Responsibilities
Employed From - To (Date)
Reason for leaving
Employer's Name
Position Title
Supervisor
Phone Number
Address
Name known by if different than above
Hours worked per week
Number of employees supervised by you
May we contact this employer?
Yes
No
If no, please state reason
Responsibilities
Employed From - To (Date)
Reason for leaving
Employer's Name
Position Title
Supervisor
Phone Number
Address
Name known by if different than above
Hours worked per week
Number of employees supervised by you
May we contact this employer?
Yes
No
If no, please state reason
Responsibilities
Employed From - To (Date)
Reason for leaving
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Education
High School or GED - School and Location
*
Diploma or GED received?
*
Yes
No
Year Received
*
Business or Technical - School and Location
Major Courses
Credit Hours Earned
Years Attended
Degree
Undergraduate Studies- School and Location
Major Courses
Credit Hours Earned
Years Attended
Degree
Graduate Studies - School and Location
Major Courses
Credit Hours Earned
Years Attended
Degree
Other Courses or Training - School and Location
Major Courses
Credit Hours Earned
Years Attended
Degree or Certificate
If known by a different name, please indicate the institution(s) and name known by.
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Professional References
Please list three professional references.
Full Name
*
Relationship
*
Company
*
Phone Number
*
Full Name
*
Relationship
*
Company
*
Phone Number
*
Full Name
*
Relationship
*
Company
*
Phone Number
*
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Other
Driver's Record Standards
Applicants for positions in which the employee is expected to operate a motor vehicle must be at least 18 years old, and will be required to present a valid Washington State driver’s license with any necessary endorsements. Driving records of applicants will be screened. Applicants will be disqualified under the following circumstances: Violations: More than two moving traffic violations within the preceding three years; or reckless driving violations within the preceding five years; or driving while intoxicated within the preceding five years. Accidents: More than one motor vehicle accident within the preceding three years for which the applicant received a traffic or criminal citation and was convicted, forfeited bail, or entered a plea of “guilty,” or “nolo contendere.”
Accomodation
Disability Status: A person with a disability is a person who has a physical or mental impairment which substantially limits one or more major life activities, or has a record of such impairment, or is perceived as having such an impairment as defined by the Americans with Disabilities Act. An accommodation may be necessary to provide a person with a disability equal employment opportunity. If you need accommodation in order to complete or participate in the application, testing or interview process, please notify the Human Resources Office at (360)454-5221.
Will you need accommodation due to disability in the application, testing or interview process?
*
Yes
No
Please provide a brief description of the accommodation requested:
Equal Employment Opportunity
Equal Employment Opportunity: It is the policy of the City to provide equal opportunity for employment to all individuals regardless of race, color, religion, sex, national origin, age, veteran status, marital status, political affiliation, sexual orientation, the presence of sensory, mental or physical disability, or other basis prohibited by federal, state or local law. This policy applies to all areas of employment, including, but not limited to, recruitment, selection, placement, retention and separation.
At-Will Status
I understand that, if employed, I am employed “at-will” and the employment relationship between the City of Stanwood and me can be terminated with or without cause and with or without notice at any time by either the City or me
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Disclaimer, Waiver and Signature
I, the below-signed, make this application as an inducement to this Employer to evaluate my application and to employ me. I have read this completed application, including the Equal Employment Opportunity statement, and I certify that entries made by me are without omission and are a full, truthful account of my present and past activities. I authorize and give the right to the City of Stanwood to make a thorough, vigorous investigation of all entries made on this form by me and other materials I have provided. Any false or misleading statement or entry on this form and other material I have provided will result in my immediate termination, if I am employed. I agree to prompt payroll deduction of overpayments made to me or amounts owed to the City of Stanwood.
Electronic Signature Agreement
*
By checking the "I agree" box below, you 1) certify the above statements to be true and correct, to the best of your knowledge, 2) agree and acknowledge that your application will not be signed in the sense of a traditional paper document, 3) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 4) you may still be required to provide a traditional signature at a later date.
I agree.
Electronic Signature
*
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Authorization to Release Information
I hereby grant permission for the City of Stanwood, to contact any and all of my current/prior employers to inquire about any and all aspects of my current and prior employment. I understand and agree that the City of Stanwood may ask for and receive information regarding my performance, duties, compensation and any other matter in any way related to my current and prior employment. I hereby waive any right I may have, now or in the future, to bring a claim against the City of Stanwood, its past or present agents, employees, officials, representatives or attorneys, in their individual or official capacities, for any information about which it may inquire or receive from any of my prior employers. I also hereby waive any right I may have, now or in the future, to bring a claim against any of my current and prior employers, as well as their past or present agents, employees, officials, representatives or attorneys, in their individual or official capacities, for any information they may provide to the City of Stanwood. I acknowledge that this permission and waiver are freely and voluntarily given to the City of Stanwood.
Full Name
*
Electronic Signature
*
Date and Time
*
Date and Time
Date and Time
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Voluntary Affirmative Action Data
The City of Stanwood provides equal opportunity in all terms, conditions and privileges of employment for all qualified job applicants and employees without regard to race, color, national origin, sex, age, marital status, veteran status, sexual orientation or the presence of disability. Providing this information is voluntary and will be kept in a confidential file separate from the application form.
Sex
Male
Female
Age
Below 18
Above 18 but below 40
Above 40
Ethnic Category
African American
Asian
Caucasian
Hispanic
Native American
Pacific Islander
Other
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Email address
This field is not part of the form submission.
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