APPLICATION FOR EMPLOYMENT CITY OF EPWORTH 191 Jacoby Drive E. PO Box 266 Epworth, IA 52045 GENERAL INFORMATION: Complete this application in detail. Print or type your responses. Resumes may be added but cannot be substituted for a fully completed application . Filing an application does not imply that you will be interviewed or hired but that your qualifications will be considered for vacancies indicated. Employees complete the Federal 1-9 form that verifies the person's identity and employment eligibility. City of Epworth is an equal opportunity employer. Qualified applicants are eligible to compete for positions without regard to race, color, national origin, sex, creed, religion, age, mental or physical disability, marital status or sexual preference. PERSONAL INFORMATION POSITION FOR WHICH YOU ARE APPLYING: _ DATE OF APPLICATION: _ 1. Last Name First Name Middle Initial 2. Street Address City State Zip Code 3. Number - Business Hours Phone Number - Evenings 4. Social Security Number: __________________________ 5. Have you served and been honorably discharged from the Military forces of the United States? Yes/No If Yes, list periods of active duty ____________________________________________ 6. Are you 18 years of age or older? Yes / No Are you legally able to work in the United States? Yes / No 7. Name any relative in the employ of City of Epworth:__________________________________________________________
APPLICATION FOR EMPLOYMENT CITY OF EPWORTH 191 Jacoby Drive E. PO Box 266 Epworth, IA 52045 GENERAL INFORMATION: Complete this application in detail. Print or type your responses. Resumes may be added but cannot be substituted for a fully completed application . Filing an application does not imply that you will be interviewed or hired but that your qualifications will be considered for vacancies indicated. Employees complete the Federal 1-9 form that verifies the person's identity and employment eligibility. City of Epworth is an equal opportunity employer. Qualified applicants are eligible to compete for positions without regard to race, color, national origin, sex, creed, religion, age, mental or physical disability, marital status or sexual preference. PERSONAL INFORMATION POSITION FOR WHICH YOU ARE APPLYING: _ DATE OF APPLICATION: _ 1. Last Name First Name Middle Initial 2. Street Address City State Zip Code 3. Number - Business Hours Phone Number - Evenings 4. Social Security Number: __________________________ 5. Have you served and been honorably discharged from the Military forces of the United States? Yes/No If Yes, list periods of active duty ____________________________________________ 6. Are you 18 years of age or older? Yes / No Are you legally able to work in the United States? Yes / No 7. Name any relative in the employ of City of Epworth:__________________________________________________________