Employment Application - Nebraska City Utilities

Applications are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job related medical condition or handicap.

Date

Position(s) applying for:*

How did you learn about this position? (News paper; our website; job service; friend; other)

Name*

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Have you filed an application here before?

Yes

No

If yes, give date:

Have you ever been employed here before?

Yes

No

If yes, give date:

Are you employed now?

Yes

No

May we contact your present employer?

Yes

No

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?

Yes

No

(Proof of citizenship or immigration status may be required upon employment)

Education

Elementary

School Name Describe Specialized Training, Apprenticeship, Skills, and Extra Curricular Activities

High School

School Name Describe Specialized Training, Apprenticeship, Skills, and Extra Curricular Activities

College/ University

School Name Describe Specialized Training, Apprenticeship, Skills, and Extra Curricular Activities

Graduate/ Professional

School Name Describe Specialized Training, Apprenticeship, Skills, and Extra Curricular Activities

Honors Received:

Additional or Other Education

Employment Experience

Start with your present or last job. Include military service assignments and volunteer activities. Exclude organization names which indicate race, color, religion, sex or national origin.

Name of Employer

Phone

Address

Street Address City State / Province / Region ZIP / Postal Code

Job Title

Supervisor

Reason for Leaving

Dates Employed

From To

Hourly Rate/Salary

Starting Final

Work Performed

Name of Employer

Phone

Address

Street Address City State / Province / Region ZIP / Postal Code

Job Title

Supervisor

Reason for Leaving

Dates Employed

From To

Hourly Rate/Salary

Starting Final

Work Performed

Name of Employer

Phone

Address

Street Address City State / Province / Region ZIP / Postal Code

Job Title

Supervisor

Reason for Leaving

Dates Employed

From To

Hourly Rate/Salary

Starting Final

Work Performed

Special Skills and Qualifications

Summarize special skills and qualifications acquired from employment or other experiences.

References

Give name, address and telephone number of three references who are not related to you and are not previous employers.

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

Applicant’s Statement

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 that this application is not nor is it intended to be a contract of employment.

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 the Company.

I agree to the statement above*

Yes

Name of Applicant*

By typing your name here you agree to adopt this field as your online signature.

Date*

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Nebraska City Utilities Application For Employment

Education

Employment Experience

Applicant’s Statement