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2. 
4. City of Weatherford, Texas Human Resources

   303 Palo Pinto Street - P.O. Box 255 - Weatherford, Texas 76086 - 817-598-4204

6. PLEASE READ INSTRUCTIONS

   Fill in blanks as accurately and neatly as possible.

   Candidates who do not meet the Education requirement may be considered if they have more relevant work experience than the position requires. Candidates selected for employment will be required to pass pre-employment checks depending on the position requirements. Pre-employment checks could include, but not limited to criminal background check, drug screen, education verification, etc. Criminal convictions will be considered on a case-by-case basis. The City of Weatherford is an Equal Opportunity Employer.

8. Title of job for which you are applying*
10. Full Name*
11. Date*
13. Address (Number and Street)*
15. Address (City)*
16. Address (State)*
17. Address (Zip Code)*
19. Email Address
20. Telephone Number*
22. Are you eighteen (18) years of age or over?*

    1. Yes
    2. No
23. When would you be available to start work?*
25. Education
27. Select your highest education level*
    -- Select One --High School DiplomaGEDCollege 1 yearCollege 2 yearsCollege 3 yearsCollege 4 yearsCollege 5+ yearsNo HS Diploma or GED
28. Do you have a college degree?*

    1. Yes
    2. No
29. Type of degree
31. Experience

    Start with your present or most recent job, military service included if applicable.

33. May inquiry be made of your present employer regarding your qualifications and record of employment?*

    1. Yes
    2. No
    3. Other
34. If other, please explain.
36. Employer's Name
38. Address, City, State
39. Phone Number
41. Dates Employed From
42. Dates Employed To
44. Your Title
45. Type of Business
47. Supervisor's Name
48. Supervisor's Email Address
50. Reason for Leaving or Wanting to Leave
52. Your Job Responsibilities
54. Previous employers in order of most recent to oldest
56. Former Employer's Name
58. Address, City, State
59. Phone Number
61. Dates Employed From
62. Dates Employed To
64. Your Title
65. Type of Business
67. Supervisor's Name
68. Supervisor's Email Address
70. Reason for Leaving
72. Your Job Responsibilities
74. Former Employer's Name
76. Address, City, State
77. Phone Number
79. Dates Employed From
80. Dates Employed To
82. Your Title
83. Type of Business
85. Supervisor's Name
86. Supervisor's Email Address
88. Reason for Leaving
90. Your Job Responsibilities
92. Former Employer's Name
94. Address, City, State
95. Phone Number
97. Dates Employed From
98. Dates Employed To
100. Your Title
101. Type of Business
103. Supervisor's Name
104. Supervisor's Email Address
106. Reason for Leaving
108. Your Job Responsibilities
110. Please explain, in detail, any time lapses in the above record due to unemployment or other reasons.
112. Have you been fired or asked to resign from a job within the last five years?*

     1. Yes
     2. No
114. If yes, please explain.
116. Have you ever been convicted of a felony in a civilian or military court? You may exclude minor traffic violations. A criminal record will not necessarily disqualify you from employment. Your case will be considered in relationship to the requirements of the particular job.*

     1. Yes
     2. No
118. If yes, please explain.
120. Are you now working for or have you ever previously worked for the City of Weatherford?*

     1. Yes
     2. No
122. If yes, please include dates and title.
124. Do you or does your spouse have any relatives presently working for or holding office in the City? City policy prohibits or limits hiring of relatives of City employees or officials in certain circumstances.*

     1. Yes
     2. No
126. If yes, please explain.
128. What license(s) do you have as it relates to the position requirements?*
130. What is the license number?*
132. Who is the issuing State/Authority?*
134. Please upload your resume.
136. Certification of Application*

     By checking the box below, I certify that the statements made by me in the above employment records are true, complete and correct to the best of my knowledge and are made in good faith. I understand that any false statement, misstatement, or omission of material facts may be cause for my dismissal or consideration for termination of employment.

     The City of Weatherford affords equal employment opportunity to all individuals regardless of race, color, religion, veteran status, creed, sex, national origin, age, disability or other protected characteristics groups under state, Federal or local Equal Opportunity laws.

     1. I agree
138. To the Applicant:

     It is the City of Weatherford's policy to provide equal employment opportunities to all applicants. In order to maintain and preserve this policy, it is important that certain information be gathered and maintained for statistical purposes only. This information will be detached from the application immediately upon receipt and before any review of your qualifications. This information will be placed on file separate from all other applicant and employee records and will not be used in any way in deciding who is recommended or selected for employment or for any other personnel action.

     Completion of this section is NOT required, but your cooperation in furnishing the requested information would be greatly appreciated.

140. Title of job applying for:
142. Race:

     1. White
     2. Asian American
     3. Spanish Surnamed
     4. Black
     5. American Indian
     6. Other
143. If other, please specify.
144. Gender:

     1. Male
     2. Female
145. Veteran:

     1. Veteran
     2. Vietnam-era Veteran
     3. Disabled Veteran
147. What prompted you to apply?

     1. Newspaper
     2. Referred by Employment Agency
     3. Referred by City Employee
     4. Walk-In
     5. Other
148. If other, please explain.
Leave This Blank:


149. 1. Receive an email copy of this form.
150. Email address

     This field is not part of the form submission.

151. Submit Submit and Print

* indicates a required field