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Personal Information

First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Are you authorized to work in the United States?*
1. Yes
2. No
Have you ever been convicted of, or pled guilty or nolo contendere to any crime other than a minor traffic violation? *
1. Yes
2. No
When answering this question, applicants are not obligated to disclose sealed or expunged records of conviction or arrest, nor are they obligated to disclose expunged juvenile records of adjudication or arrest.
Do you have any relatives employed by the City of Warrenville? If yes, state name and relationship. *
1. Yes
2. No
Name and relationship of relative
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Position Information

Which position are you applying for?*
Type of employment desired*
1. Full Time
2. Part Time
1. Internship
1. Temporary
1. Summer
Salary desired*
Hours of work (per week) desired*
How did you learn about this job opening?*
Have you ever been employed by the City of Warrenville? If yes, state position and dates of employment. *
1. Yes
2. No
Position and dates of employment
Are you at least 18 years of age?*
1. Yes
2. No
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Education

Please provide your education and training history.
If you are attaching a resume that includes your education and training history, skip to the next section.
High School
Address
Highest Grade Completed
College
Address
Degree
Other
Address
Degree
Military Service and Branch
List any training, courses, or workshops relating to the type of work for which you are applying. Also list certifications or other skills that you feel may qualify you for the position you are seeking.
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Employment History

Begin with your most recent employer. This information must be provided below.
Company*
Position*
Supervisor*
Phone Number*
May we contact your previous supervisor for a reference?*
1. Yes
1. No
Address*
Responsibilities*
Employed From - To (Date)*
Reason for Leaving*
Company*
Position*
Supervisor*
Phone Number*
May we contact your previous supervisor for a reference?*
1. Yes
1. No
Address*
Responsibilities*
Employed From - To (Date)*
Reason for Leaving*
Company*
Position*
Supervisor*
Phone Number*
May we contact your previous supervisor for a reference?*
1. Yes
1. No
Address*
Responsibilities*
Employed From - To (Date)*
Reason for Leaving*
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References

Please list three professional references.
If you are attaching a resume that includes professional references, skip to the next section.
Full Name
Relationship
Company
Phone Number
Full Name
Relationship
Company
Phone Number
Full Name
Relationship
Company
Phone Number
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Disclaimer & Signature

I hereby certify that the information set forth in this employment application is true and complete to the best of my knowledge. I understand that falsified statements or omissions of facts on this application shall be considered sufficient cause for termination of employment or cancellation of this application.
In consideration of my application for employment, I authorize the City of Warrenville to make investigations concerning my fitness for employment with the City of Warrenville. I understand that, for certain positions, inquiries by the City of Warrenville may include investigating criminal convictions, checking credit records and/or contacting former employers and other references listed on this application and I agree to cooperate in such investigations.
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
EQUAL OPPORTUNITY EMPLOYER
The City of Warrenville is an equal-opportunity employer. In accordance with federal, state and local laws, the City of Warrenville is committed to recruit, hire, promote, train and evaluate all personnel without regard to race, color, religion, sex, age, national origin, citizenship status, sexual orientation, physical/mental disability, or past/present/future status in the uniformed services of the United States. Job applicants are evaluated solely on their ability to perform job requirements.
Applicant Signature*

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