Sanger, CA

Personal Information & Education

Employment Application For
Position Title
Application Information
Full Name
Date
Date
Street Address
City
State
ZIP Code
Phone
Email
Do you have any physical condition which may limit your ability to perform to job applied for?
1. Yes
2. No
Offer of employment may be made contingent upon passing a physical examination.
Are you a citizen of the United States?
1. Yes
2. No
If no, are you authorized to work in the U.S.?
1. Yes
2. No
Have you ever been discharged or forced to resign from any position?
1. Yes
2. No
If yes, please explain.
Would you object to having your present employer or past employers contacted in regard to your work record, qualifications, character, etc.?
1. Yes
2. No
If yes, please explain.
Do you speak a language fluently other than English?
1. Yes
2. No
If yes, please specify.
Education
High School
Address
From
To
Did you graduate?
1. Yes
2. No
Diploma
College
Address
From
To
Did you graduate?
1. Yes
2. No
Degree
Other
Address
From
To
Did you graduate?
1. Yes
2. No
Degree
Other Training
For example, special courses, work training programs, and military training. Also, list certificates or licenses of Professional or Vocational competence.
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References, Employment History & Disclaimer

References
Please list three personal references. Do not give names of relatives.
Full Name
Business or Occupation
Company
Phone
Address
Full Name
Business or Occupation
Company
Phone
Address
Full Name
Business or Occupation
Company
Phone
Address
Previous Employment
Please list all jobs and any periods of unemployment in the last 10 years.
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
Employment Dates
Employment Dates Start Date
—
Employment Dates End Date
Reason for Leaving
May we contact your previous supervisor for a reference?
1. Yes
2. No
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Employment Dates
Employment Dates Start Date
—
Employment Dates End Date
Reason for Leaving
May we contact your previous supervisor for a reference?
1. Yes
2. No
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Employment Dates
Employment Dates Start Date
—
Employment Dates End Date
Reason for Leaving
May we contact your previous supervisor for a reference?
1. Yes
2. No
Military Service
Branch
Service Dates
Service Dates Start Date
—
Service Dates End Date
Disclaimer & Signature
Do you have any relatives working for the City of Sanger?
1. Yes
2. No
I certify that my answers are true to the best of my knowledge and belief.
If this application leads to employment, I understand that untruthful or misleading answers are cause for rejection of my application, removal of my name from eligibility list or dismissal from employment.
Signature
Date
Date
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Volunteer in Police Services Supplemental Application

How did you learn of recruitment for this position?
Volunteer in Police Services Supplemental Application
Other Names Used
List special skills, and/or hobbies.
List current or previous experience with organizations, civic groups, and clubs.
List previous volunteer experience.
Which area(s) are you interested in volunteering?
1. Administrative/Office Work
2. Animal Shelter
3. Citizens on Patrol
4. Community Programs/Events
5. Neighborhood Watch
6. School Events/Safety Classes
7. Other
Please list any other services/talents that you are interested in providing?

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Volunteer in Police Services Supplemental Application

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