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Tama County Application of EmploymentTAMA COUNTY IOWAAPPLICATION FOR EMPLOYMENTSecondary Road Department1002 E. 5th Street, Tama, IAAdministration Building104 W. State Street, Toledo, IASheriff’s Office and Jail100 N. Main Street, Toledo, IACompleting this application is your first step towardjoining a dynamic workforce dedicated to publicservice.In order to present the strongest, mostaccurate record of your qualifications andskills, please read this packet and thejob announcement carefully prior topreparing your application.Tama County is an equal opportunity employer. We consider applicants for all positions without regard toage, race, creed, color, sex (including pregnancy), sexual orientation, gender identity, national origin,religion, disability, genetic information, marital or veteran status, or any other legally protected status.HR/Application4.2018
Tama County Application of EmploymentInstructions for Completing ApplicationBefore ApplyingApplication TipsNow What?Obtain a copy of the jobannouncement that you areinterested in applying for. Jobannouncements are availableat the department posting thejob and/or Tama County website at www.tamacounty.orgWhen filling out your applicationType or print clearly in ink.NotificationThe Department you appliedto will notify you of yourapplication's status as soonas possible after the closingdate. Please allow time forthe necessary verification ofyour qualifications.Compare your education,experience and physical abilitywith the requirements listedon the job description. If youmeet the requirements,proceed with the applicationprocess.Non-USA Citizens: ResidentAliens & Non-Resident Aliens:You must provide the properdocuments as proof of yourlegal right to work in the USAwith this job application.HR/Application4.2018Provide all requestedinformation.Emphasize your experience andeducation that relates directly tothe requirements of the job.Submit application (with allrequested information) by closingdate of position.Please be advised that becauseTama County is a public entity, itis subject to the requirements ofChapter 22, Code of Iowa,regarding the examination ofpublic records, and thisApplication may be subject toexamination under that statute.Driving RecordYour authorization to allow theCounty to receive a report ofyour driving record will also allowthe County to continuemonitoring your driving record ifyou are employed. To receivemileage reimbursement for usingyour personal vehicle on Countybusiness, you must have a gooddriving record.TestingIf you've met therequirements and a writtenexam is required, you willreceive an exam schedulenotice with furtherinstructions.Exam AssistanceAssistance will be providedto persons of disabilitywhose condition wouldinterfere with taking anexam.Pre-employment PhysicalIf you are offeredemployment, thedepartment may request aphysical from your doctorprior to your first day ofwork. You must take a copyof the job description toyour doctor in order forhim/her to evaluate yourability to physically performthe essential workdescribed.
Tama County Application of EmploymentAPPLICATION FOR EMPLOYMENTTAMA COUNTY, IOWAGENERAL INFORMATION (Please be advised that because Tama County is a public entity, it issubject to the requirements of Chapter 22, Code of Iowa, regarding the examination of public records, andthis Application may be subject to examination under that statute).POSITION APPLIED FOR: (Job title)COUNTY DEPARTMENT:HOW DID YOU LEARN ABOUT US?DATE:LAST NAMEFIRST NAMEADDRESS:MIDDLECITYHOME TELEPHONECELL PHONEBest time to contact you is: A.M. P.M.STATEZIP CODEEMAIL ADDRESSPreferred method of contact:BACKGOUND ESYESNONONOIf you are under 18 years of age, can you provide required proof of your eligibility to work?Have you ever filed an application with Tama County before?If yes, give date and position applied for: .Have you ever been employed by Tama County before?If yes, give dates and position held: .Do any of your friends or relatives, other than spouse, work for Tama County?If yes, provide name and position or department for each person: .Are you currently employed?May we contact your present employer?Are you prevented from lawfully becoming employed in this country because of Visa or Immigrationstatus? Proof of citizenship or immigration status will be required if an offer of employment is made.Have you ever been discharged or asked to resign from employment?Have you ever been convicted of a crime other than a conviction for a minor traffic violation?Has your driver’s license ever been suspended or revoked?IF YOU HAVE ANSWERED “YES” TO ANY OF THE FOREGOING QUESTIONS, PLEASE PROVIDE ALL PARTICULARS ON ANATTACHED SHEET. A “YES” ANSWER DOES NOT AUTOMATICALLY DISQUALIFY YOU FROM CONSIDERATION OF YOURAPPLICATION OR FROM EMPLOYMENT.HR/Application4.2018
Tama County Application of EmploymentVETERANS PREFERENCEChapter 35C of the Code of Iowa provides certain rights, including preference in hiring if equally qualified, to certainVeterans of United States Military Service. Qualification for these rights is defined in the statute.Are you a Veteran of the United States Military Service:YesNoBranch of Service and dates of Active Duty:Are you a member of the Reserves or National Guard?YesNoAny person who may wish to claim a Veterans Preference must submit a copy of a certified form DD214 by thedeadline set for the receipt of applications for the position for which the person is applying.QUALIFICATIONSPlease read the attached position description for the position of: .Do you know of any reason that you would not be able to perform the essential functions of this position, with orwithout a reasonable accommodation?YesNoIf you have answered “Yes” to this question, you may provide, on a voluntary basis, information which you believewould help to explain you answer. (You are not required to provide this information at this time):HR/Application4.2018
Tama County Application of EmploymentEMPLOYMENT EXPERIENCE (Start with your present or last employer. Include any job-relatedmilitary service assignments and volunteer activities. You may exclude organizations which would reveal aprotected status as identified on Page One of this application).EmployerDates EmployedFromToWork PerformedAddressTelephone NumbersHourly Rate/SalaryStartJob TitleFinalSupervisorReason for LeavingEmployerDates EmployedFromToWork PerformedAddressTelephone NumbersHourly Rate/SalaryStartJob TitleFinalSupervisorReason for LeavingEmployerDates EmployedFromToWork PerformedAddressTelephone NumbersHourly Rate/SalaryStartJob TitleFinalSupervisorReason for LeavingEmployerDates EmployedFromToAddressTelephone NumbersHourly Rate/SalaryStartJob TitleReason for LeavingHR/Application4.2018SupervisorFinalWork Performed
Tama County Application of EmploymentEDUCATIONCircle highest year of education completed1 2 3 4 5 6 7 8 9 10 11 12High School graduate or equivalent (GED)?13 14 15 16 (other)YesNoName and Location of Schools Attended or Vocational Training Obtained Beyond High SchoolDegree/CertificationPROFESSIONAL, TRADE, BUSINESS OR CIVIC ACTIVITIES AND OFFICES HELDYou may exclude membership which would reveal a protected status as identified on Page One of this pPhoneHR/Application4.2018
Tama County Application of EmploymentADDITIONAL INFORMATION State any additional information you feel may be helpful to us inconsidering your application.HR/Application4.2018
Tama County Application of EmploymentAPPLICANT’S STATEMENTI certify that answers given herein are true and complete.I authorize investigation of all statements contained in this Application for Employment as may be necessary inarriving at an employment decision.I authorize Tama County to conduct a check of the status of my driver’s license and my driving record and agree tosign an authorization for this specific purpose.This Application for employment shall be considered active for a period of time not to exceed 45 days. Any applicantwishing to be considered for employment beyond this time period should inquire as to whether or not applicationsare being accepted at that time.I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employmentrelationship with Tama County is of an “at will” nature, which means that the Employee may resign at any time, andthe 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 isspecifically acknowledged in writing by an authorized executive of Tama County.I understand that any offer of employment that is extended to me is considered to be a conditional offer and issubject to successful completion of all background checks. Identifying information such as my social security numberand driver’s license number will be requested at the post-offer, pre-employment stage.In the event of employment, I understand that false or misleading information given in my Application or interview(s)may result in discharge, also, that I am required to abide by all rules and regulations of the Employer.I agree to give Tama County permission to complete appropriate background checks, and agree to signpermission/authorization documents so that this can be accomplished. Yes NoSignature of ApplicantDateFOR DEPARTMENT USE ONLYArrange Interview?YesNoRemarksInterviewer DateHR/Application4.2018
Tama County Application of Employment HR/Application4.2018 TAMA COUNTY IOWA APPLICATION FOR EMPLOYMENT Secondary Road Department 1002 E. 5th Street, Tama, IA Sheriff's Office and Jail 100 N. Main Street, Toledo, IA Administration Building 104 W. State Street, Toledo, IA Completing this application is your first step toward
