Employment Application

Application Information
Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Date
MM slash DD slash YYYY
Desired Salary
Please enter a number greater than or equal to 0.
Position Applied For:*
List Licenses/Certificates related to position applied for:
Drivers License Number:*
Driver’s License Class/Endorsements:
Number of moving violations in the past 3 years?*
Possess a valid driver's license?*
- Yes
- No
Are you a citizen of the United States?*
- Yes
- No
If no, are you authorized to work in the U.S.? States?*
- Yes
- No
Have you ever worked for this company?*
- Yes
- No
If so, when?*

Education
High School:
Address of High School:
From
Month
Day
Year
To
Month
Day
Year
Did you Graduate
- Yes
- No Degree
College
Address of College:
From
Month
Day
Year
To
Month
Day
Year
Did you Graduate
- Yes
- No Degree
Other
Address of Other:
To
Month
Day
Year
From
Month
Day
Year
Did you Graduate
- Yes
- No Degree

*Etowah Water & Sewer Authority is an equal opportunity employer and provides fair and equal employment opportunities to all applicants for employment and employees without regard to race, color, religion, natural origin, citizenship status, age, sex, disability, veteran’s status, or political affiliation.
Refrences
Please List Three Professional references
Name
First Last
Relationship
Company
Phone
Address
Street Address City State / Province / Region ZIP / Postal Code
Name
First Last
Relationship
Company
Phone
Address
Street Address City State / Province / Region ZIP / Postal Code
Name
First Last
Relationship
Company
Phone
Address
Street Address City State / Province / Region ZIP / Postal Code

Previous Employment
Company:
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor
Job Title
Starting Salary
Please enter a number greater than or equal to 0.
Ending Salary
Please enter a number greater than or equal to 0.
Responsibilities
From
Month
Day
Year
To
Month
Day
Year
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Company:
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor
Job Title
Starting Salary
Please enter a number greater than or equal to 0.
Ending Salary
Please enter a number greater than or equal to 0.
Responsibilities
From
Month
Day
Year
To
Month
Day
Year
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Company:
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor
Job Title
Starting Salary
Please enter a number greater than or equal to 0.
Ending Salary
Please enter a number greater than or equal to 0.
Responsibilities
From
Month
Day
Year
To
Month
Day
Year
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Upload a copy of your resume: ( File Size limit is 2MB)
Max. file size: 3 MB.

Disclaimer*
BY CHECKING THIS BOX, I AGREE THAT I HAVE READ AND UNDERSTAND THE STATEMENTS.
PLEASE READ THIS IMPORTAN INFORMATION BELOW. ASK FOR CLARIFICATION IF NEEDED.

The undersigned has applied for employment with Etowah Water & Sewer Authority and hereby authorizes Etowah Water & Sewer Authority to contact my current and former employers and references for the purpose of acquiring information regarding me; I hereby authorize such employers and references to supply such information verbally or in writing to Etowah Water & Sewer Authority. In consideration for their furnishing such information, I hereby waive any and all claims against such former employers and references which may arise from their furnishing such information. I understand Etowah Water & Sewer Authority has a Substance Abuse Prevention Program which includes drug testing. I agree to comply with applicable Etowah Water & Sewer Authority policy.

I understand that once offered a position I will be required to complete a drug screening. I certify that the answers given by me to all of the questions on this application are to the best of my knowledge and belief true and correct. I further affirm that I have not knowingly withheld any facts or circumstances that would detrimentally affect my application for employment, and I understand that any misleading or incorrect statement may render this application void and would be cause for dismissal, if employed.

I AGREE THAT IF HIRED, ETOWAH WATER & SEWER AUTHORITY OR I MAY TERMINATE MY EMPLOYMENT AT ANY TIME WITH OR WITHOUT CAUSE. I UNDERSTAND THAT NO POLICY, PRACTICE, PROCEDURE, OR STATEMENT BY ANY ETOWAH WATER & SEWER AUTHORITY REPRESENTATIVE SHALL LIMIT OR ALTER THIS AT-WILL EMPLOYMENT RELATIONSHIP.
Comments
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Employment Application

Step 1 of 6 - Information

Application Information

Military Service

Education

Refrences

Previous Employment

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