Evans County, GA – Employment Application

Employment Application

"*" indicates required fields

Step 1 of 6

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Position Applied For*

Title First Name Last Name

Current Address*

Street Address Address Line 2 City State ZIP Code

Telephone*

Email*

File Upload*

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 10 MB, Max. files: 5.

BOTH A FULLY COMPLETED APPLICATION AND RESUME ARE REQUIRED FOR EMPLOYMENT CONSIDERATION. Please upload your resume, cover letter, and any other pertinent documents. You must do so in either PDF or Word (.doc or .docx) format

Other Relevant Information

Are You eighteen years old or older?*

Are You Eligible To Work in the U.S.A.?*

Have You Ever Been Convicted Of A Crime which has not been dismissed or sealed by court?*

Excluding minor traffic offenses

If Yes, Describe in detail

In the past two years, have you used ANY illegal drug?*

If Yes, What Drug(s) and When

Have You Ever Been Employed By Evans County?*

If Yes, When?

When Are You Available To Begin?*

MM slash DD slash YYYY

List Any Special Skills, Experience, or Qualifications

Military experience, licenses, etc.

Are You Able To Perform The Essential Job Functions of The Position Applied For?*

Personal References

Reference #1 Name and Occupation*

Reference #1 Address*

Reference #1 Telephone*

Reference #2 Name and Occupation*

Reference #2 Address*

Reference #2 Telephone*

Reference #3 Name and Occupation*

Reference #3 Address*

Reference #3 Telephone*

Record of Education

High School Name*

High School - Number of Years*

High School - Diploma or Degree Received*

College or University

College - Number of Years

College - Diploma or Degree Received

Other Education

Technical School or special training

Other - Number of Years

Other - Diploma or Degree Received

Employment History

List present and past employment beginning with your most recent.

Name and Address of Company*

Start Date*

MM slash DD slash YYYY

End Date*

MM slash DD slash YYYY

Ending Salary*

Reason for Leaving*

Contact Name and Number*

Describe Your Work*

Name and Address of Company*

Start Date*

MM slash DD slash YYYY

End Date*

MM slash DD slash YYYY

Ending Salary*

Reason for Leaving*

Contact Name and Number*

Describe Your Work*

Name and Address of Company*

Start Date*

MM slash DD slash YYYY

End Date*

MM slash DD slash YYYY

Ending Salary*

Reason for Leaving*

Contact Name and Number*

Describe Your Work*

I hereby give my permission to contact the employers listed on the previous page concerning my prior work experience.*

Enter Your Full Legal Name as Your Signature

List Any Employers You DO NOT wish us to contact

Please Read and Sign Below

The facts set forth in my application for employment are true and correct. I understand that if employed, any false statement on this application may result in my dismissal. I further understand that this application is not and is not intended to be a contract of employment, nor does this application obligate the employer in any way if the employer decides to employ me.

Signature (Enter Your Full Legal Name)*

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