CIVILIAN EMPLOYMENT Application Step 1 of 10 10% Employment ApplicationPosition(s) Applying For:(Required) Jail Clerk Civil Process Clerk Records Clerk Control Room Operator CID Secretary Name(Required) First Middle Initial Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Number(Required)Email Address(Required) Date of Birth(Required) MM slash DD slash YYYY If you are under 18 years of age, can you provide required proof of your eligibility to work? Yes No Have you ever filed an application with us before?(Required) Yes No Date of Previous Application MM slash DD slash YYYY Have you ever been employed with us before?(Required) Yes No Date of Previous Employment MM slash DD slash YYYY Are you currently employed?(Required) 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? (Proof of citizenship or immigration status will be required upon employment)(Required) Yes No On what date would you be available to work?(Required) MM slash DD slash YYYY Are you available to work:(Required) Full Time Part Time Shift Work Temporary Are you currently on “lay-off” status and subject to recall?(Required) Yes No Can you travel if a job requires it?(Required) Yes No Have you been convicted of a felony within the last 7 years?(Required) Yes No Please Explain Felony Conviction EducationName of Elementary School Address of Elementary School Street Address Address Line 2 City State / Province / Region ZIP / Postal Code High SchoolName of High School Address of High School Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Years of High School Completed1234Undergraduate CollegeName of Undergraduate College Address of Undergraduate College Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Course of Study Years of Undergraduate School Completed1234Diploma or Degree Graduate ProfessionalName of Graduate/Professional College Address of Graduate/Professional College Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Years of Undergraduate School Completed1234Diploma or Degree Language SkillsIndicate a foreign language you can speak, read, and/or write. Please rate your ability to speak that language Fluent Good Fair Please rate your ability to read in that language Fluent Good Fair Please rate your ability to write in that language Fluent Good Fair Do you speak a third language?Please Select OneYesNoIndicate the third foreign language you can speak, read, and/or write. Please rate your ability to speak that language Fluent Good Fair Please rate your ability to read in that language Fluent Good Fair Please rate your ability to write in that language Fluent Good Fair Do you speak a fourth additional languages?Please Select OneYesNoIndicate the fourth foreign language you can speak, read, and/or write. Please rate your ability to speak that language Fluent Good Fair Please rate your ability to read in that language Fluent Good Fair Please rate your ability to write in that language Fluent Good Fair Additional SkillsDescribe any specialized training, apprenticeship, skills and extra-curricular activities.(Required)Do you have military expreience?(Required) Yes No Describe any job-related training received in the United States military. Employment Experience List your current job and any other employment within the last five years (minimum of two employers). Include job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities, or other protected status. Any inaccurate statements or omission of information will be considered falsification of this application.Employer Name(Required) Employer Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Employer's Phone #(Required)Supervisor's name(Required) First Last Job Title/Work Performed(Required) Date Employment Started(Required) MM slash DD slash YYYY Date Employment Ended MM slash DD slash YYYY Starting Wage(Required) Final or Current Wage(Required) Reason for Leaving(Required)Add Second Employer?(Required)Please Select OneYesNoSecond EmployerEmployer Name(Required) Employer Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Employer's Phone #(Required)Supervisor's name(Required) First Last Job Title/Work Performed(Required) Date Employment Started(Required) MM slash DD slash YYYY Date Employment Ended(Required) MM slash DD slash YYYY Starting Wage(Required) Final Wage(Required) Reason for Leaving(Required)Add Third Employer?Please Select OneYesNoThird EmployerEmployer Name Employer Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Employer's Phone #Supervisor's name First Last Job Title/Work Performed Date Employment Started MM slash DD slash YYYY Date Employment Ended MM slash DD slash YYYY Starting Wage Final Wage Reason for LeavingAdd Fourth Employer?Please Select OneYesNoFourth EmployerEmployer Name Employer Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Employer's Phone #Supervisor's name First Last Job Title/Work Performed Date Employment Started MM slash DD slash YYYY Date Employment Ended MM slash DD slash YYYY Starting Wage Final Wage Reason for Leaving Other QualificationsList professional, trade, business or civic activities and offices held. (You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status).Summarize special job-related skills and qualifications acquired from employment or other experiences.State any additional information you feel may be helpful in considering your application.Are you capable of performing in a reasonable manner the activities involved in the job or occupation for which you have applied? DO NOT ANSWER UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.(Required) Yes No Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING. ReferencesMinimum of three unrelated references. Please note all references will be contacted unless otherwise advised.Reference 1: Name/Address/Phone Number(Required)Reference 2: Name/Address/Phone Number(Required)Reference 3: Name/Address/Phone Number(Required) Applicant's StatementApplicant's Statement(Required) 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. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.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 the rules and regulations of the employer.Applicant's Statement(Required) BY SELECTING THIS BOX AND ENTERING MY NAME BELOW, I AM ELECTRONICALLY SIGNING THIS FORM.Signature of Applicant(Required) Select the appropriate box that applies.(Required) The above signature is my certified electronic signature. My printed name above is to be treated as my electronic signature. Date(Required) MM slash DD slash YYYY Release AuthorizationRelease Authorization(Required) I hereby authorize the release of any military, medical, employment, credit, and school records or transcripts to the Tazewell County Sheriff's Office. I further authorize the Tazewell County Sheriff's Office to investigate my character and background, and to solicit any information that might be used in the evaluation of my employment potential with the Tazewell County Sheriff's Office. I also authorize an investigation of all statements made in my application for employment with the Tazewell County Sheriff's Office. In making such authorization, I release the contributor, agents of the contributor, the county of Tazewell, State of Illinois, and its agents from all liability for any damage arising there from. Applicant's Statement(Required) BY SELECTING THIS BOX AND ENTERING MY NAME BELOW, I AM ELECTRONICALLY SIGNING THIS FORM.Name of Applicant(Required) First Last Driver's License Number(Required) Date of Birth(Required) MM slash DD slash YYYY Date of Application(Required) MM slash DD slash YYYY Previous NamesPrevious Name 1 First Last Previous Name 2 First Last Previous Name 3 First Last Previous Name 4 First Last
