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Employment Application
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City of Winooski Employment Application
Applicant Information
Today's Date
*
Today's Date
First Name
*
Middle Name
Last Name
*
Phone Number
*
Email
*
Address
*
City
*
State
*
Zip Code
*
Position You're Applying For
*
Where Did You Hear About This Position?
*
-- Select One --
winooskiv.gov
Social Media
Seven Days
Indeed.com
Craigslist
Other
Are You Eligible to Work in the United States?
*
Yes
No
Does This Position Require a CDL?
Yes
No
Have You Ever Worked for the City of Winooski Before?
*
Yes
No
If Yes, When?
If Yes, When?
Do You Have Relatives Who Work for the City of Winooski?
*
Yes
No
If Yes, Who?
Education
Name of High School Attended
*
How Many Years Did You Attend?
*
Have You Graduated?
*
Yes
No
Address
City
State
Zip Code
Name of College Attended
How Many Years Did You Attend?
Have You Graduated?
Yes
No
Address
City
State
Zip Code
Other School
How Many Years Did You Attend?
Did You Graduate?
Yes
No
Employment
Name of Current Employer
*
Dates Employed
*
Dates Employed Start Date
—
Dates Employed End Date
Responsibilities
*
Reason for Leaving
*
Name of Supervisor
*
May we Contact this Employer and or Supervisor for a Reference?
*
Yes
No
Name of Previous Employer
*
Dates Employed
*
Dates Employed Start Date
—
Dates Employed End Date
Responsibilities
*
Reason for Leaving
*
Name of Supervisor
*
May we Contact this Employer and or Supervisor for a Reference?
*
Yes
No
Name of Previous Employer
*
Dates Employed
*
Dates Employed Start Date
—
Dates Employed End Date
Responsibilities
*
Reason for Leaving
*
Name of Supervisor
*
May we Contact this Employer and or Supervisor for a Reference?
*
Yes
No
Professional References
Full Name
*
Relationship
*
Phone
*
Email
*
Company
*
Address
*
Full Name
*
Relatonship
*
Phone
*
Email
*
Company
*
Address
*
Full Name
*
Relationship
*
Phone Number
*
Email Address
*
Company
*
Address
*
Additional Information
Please list any other relevant certifications, skills, education, training or licenses you possess:
*
Did You Serve in the Military?
What Branch?
Rank at Discharge
Military Experience Relevant to Position Applied for:
Non-Discriminiation Policy
It is the policy of this Municipality to provide equal opportunity to apply to all applicants and employees without regard to race, color, religion, sex, national origin, ancestry, place of birth, age, marital status, pregnancy status, genetic information, physical or mental condition, HIV status, veteran status, sexual orientation, gender identity, or other category protected by state or federal law. No question is asked on this application or during the application process for the for the purpose of excluding any applicant due to the aforementioned protected categories or other category protected by law.
Disclaimer and Signature
I understand omissions or misrepresentati ons may be cause for rejection or, if employed, may be cause for immediate dismissal. I hereby authorize any former employer, person, firm, corporation or educational institution listed heron including this municipality to answer any and all questions, provide documents and agree to hold all persons harmless for giving any and all truthful information within their knowledge or records. I understand this is a preliminary application and not a contract for employment. Furthermore, in the event I am hired, my employment shall be completely voluntary and may be terminated at will at any time for any non-discriminat ory reason upon notice by either myself or the municipality. I agree to comply with all reasonable rules of the municipality and condition of employment.
Upload You Resume
*
By clicking yes, I hereby attest that all information provided by me is true and correct to the best of my knowledge.
*
Yes
Full Name
*
Today's Date
*
Today's Date
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