Job Application

Job Application

Personal Information

Address *
Address
Street
Apt/Suite/Trlr #
City
State
Zip
Check the following options you would consider: *
Do you have any commitments? *

Education & Training

Diploma Received?
Degree Received?
Degree Received?
Degree Received?
Do you have a valid driver's license in this state?
Military Service? *

General Information

Can you, after employment, submit verification of your legal right to work in the United States?
Are you 16 years old or over?
Were you previously employed by City of Nogales? *
Can you perform the essential functions of the job? *
Do you require special accommodation to perform the job? *

Employer History

Address *
Address
Street
Apt/Suite/Trlr #
City
State
Zip
May we contact? *
Type of Employment *

Business References

Emergency Contact

Address *
Address
Street
Apt/Suite/Trlr #
City
State
Zip

Additional Information

Criminal Record Information

Exclude any records expunged, annulled, sealed, or discharged under first-offender law.
During the past ten years, have you ever been convicted of, plead guilty to, or received probation, deferred adjudication, or any other type of alternative method of supervision or correction for a misdemeanor, having a penalty of imprisonment or a fine of more than $500, or a felony? (Answering Yes is not an automatic bar to employment but will be considered in relation to specific job requirements.) *
Have you been convicted of a crime (exclude minor traffic cases; includes DUIs)? *
Are criminal charges now pending against you? *

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I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to be the best of my knowledge. I also agree that falsified information or significant omissions may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date.

I authorize all persons listed above (and on the accompanying resume, if any) to give City of Nogales any and all information concerning my previous employment and education and any pertinent information they may have, personal or otherwise, and release all parties, such persons and City of Nogales, from liability for any damage that may result from furnishing same to City of Nogales.

I understand that City of Nogales may obtain a consumer and/or investigating consumer report for employment purpose that may include information as to my character, general reputation, personal characteristics, mode of living, work experience and performance, along with reasons for termination of past employment. The report may also contain a records check of driving, criminal, credit, education, degrees, professional licenses and/or certification records depending on the position. By signing this application, I authorize the procurement of a consumer and/or investigative consumer report by City of Nogales as part of the pre-employment background investigation, and if hired, at any time during my employment. I further release City of Nogales from all liability in connection with any consumer report performed.

I understand and agree that I may be required to take a drug and alcohol screening test. I hereby give my voluntary consent for a blood and/or urine sample to be collected from me and submitted for testing. I also consent to the release of the test result to City of Nogales for its use. I understand that any positive drug or alcohol result may preclude my employment.

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520-287-6571

Address

777 N. Grand Ave
Nogales, AZ, 85621

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