Application

Name *

First

Last

Male
Female

ADDRESS *

Email *

Email

Confirm Email

PHONE *

BIRTHDATE *

DRIVER'S LICENSE ( STATE ISSUED, LICENSE #)

ARE YOU A VETERAN OF THE UNITED STATES ARMED FORCES

YES
NO

CITIZENSHIP *

Resident foreign national (Alien who has been admitted for permanent residence, must have Alien Registration Card, Form 1-151)
Non-resident firein national ( Alen admitted temporarily for specific purposes & periods of time)
United States Citizen

POSITIONS APPLYING FOR

Were you ever discharged or forced to resign from employment due to misconduct or unsatisfactory services?Prior discharges or forced resignations will not necessarily disqualify you from employment. *

YES
NO

Have you EVER been convicted, under any name, of an offense against the law, other than minor traffic violations? A conviction does not mean that you cannot be hired; the offense & how recently you were convicted will be evaluated in the relation to the job for which you are applying. *

YES
NO

Can you with or without reasonable accomodation, perform the essential functions of the job applied for? *

YES
NO

Have you ever applied to the City of Geary before? *

YES
NO

Do you have a current, valid Oklahoma State driver's license? *

YES
NO

Is anyone related to you by blood or by marriage who works for the City of Geary? *

YES
NO

Have you ever been fired, asked to resign, or accepted resignation rather than termination? *

YES
NO

Education ( High School, College, Trade Schools, Graduation Status, College Hours, etc)

Please list any and all Professional Licenses ( status, state issued, include license number where applicable)

Specialized Skills: check all that apply

Other Skills: Describe any job-related skills, special training, or licenses that you have

Work Experience - Please Provide last 3 employers ( Company, Contact Person, Phone Number, Length of Employment)

References - Please provide 3 references not realted to you ( name, phone number, relationship, years known)

I hereby certify that all of the information provided by me in this application is correct and complete to the best of my knowedge. I understand that the falsification, misrepresentation or omission of any facts in these documents may be cause for denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery, including after hire. *

I understand

I understand that submission of an application does not guaruntee employment. I further understand that, should an offer of employment be extended by the City of Geary such empployment is "at-will". "At-will means that employment with the City of Geary is for no specified duration and may be terminated by the City of Geary or the Mayor at any time, with or without cause or notice. *

I understand

I understand that if offered a position with the City of Geary, I may be required to submit to a pre-employment drug and alcohol screen by a qualified health professional. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of a drug and alcohol screen may result in the withdrawl of any employment offer or termination of the employment if already employed. *

I understand

I understand that a comprehensive background investigation may be conducted as pasrt of the employment process. I hereby authorize any and all schools, former employers, reference, courts and any other who have information about me to provide such information to the City of Geary and/or any of its representatives, and I relase all parties involved from any and all liability for any and all damage that may result from providing such information. I understand that all offers of the employment are contingent upon the City of Geary's satisfaction with the results of the background investigation. *

I understand

I understand that this application i considered current for twelve months for postion specified on this application. If I wish to be considered for employment after this time period must complete and submit a new application. *

I understand

BY ELECTRONICALLY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO ABOVE STATEMENTS *