City of Caledonia Employment and Job Applications

Name*

First Middle Last

Email Address*

Phone Number*

Best time to contact you

Address*

Street Address Address Line 2 City State ZIP Code

Position you are applying for*

Availability*

Days
Evenings
Weekends

Capacity*

Part-time
Full-time
Temporary/PRN

May we contact your current employer?*

No
Yes

Please add a name, email and phone of current employer

Have you ever had any job related training in the United States Military?*

No
Yes

List job related training below

Are you capable of performing the essential functions of this position?*

No
Yes

Indicate any foreign languages you can speak, read and/or write.

Reference 1

Cannot be related to you or a previous employer.

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Reference 2

Cannot be related to you or a previous employer.

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Reference 3

Cannot be related to you or a previous employer.

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Education: High School

Name

Location

Diploma/Degree

Training/Honors/Etc.

Check all the years completed.

1
2
3
4

Education: Trade School

Name

Location

Diploma/Degree

Training/Honors/Etc.

Check all the years completed.

1
2
3
4

Education: College/University

Name

Location

Diploma/Degree

Training/Honors/Etc.

Check all the years completed.

1
2
3
4

Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status.

Employment 1

Employer Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Job Title

Supervisor

Reason for Leaving

Date Began

Date Ended

Starting Rate

Final Rate

Work Performed/Responsibilities:

Employment 2

Employer Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Job Title

Supervisor

Reason for Leaving

Date Began

Date Ended

Starting Rate

Final Rate

Work Performed/Responsibilities:

Employment 3

Employer Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Job Title

Supervisor

Reason for Leaving

Date Began

Date Ended

Starting Rate

Final Rate

Work Performed/Responsibilities:

Special Skills and Qualifications

Summarize special job-related skills and qualifications acquired from employment or other experiences.

If you were unemployed at any time since leaving school, please indicate what you were doing during this time.

Upload Resume

Accepted file types: pdf, doc, docx, jpg, jpeg.

Applicant's Statement & Agreement

By submitting this application, I hereby authorize the employers listed above to release all information to City of Caledonia. I also understand that this authorization is valid for 60 days. I waive any liability to the employers listed above, and its employees, from any claims of action for disclosure of information that could adversely affect any new employment opportunity.
I certify that the above information is true and correct and give authorization for investigation of all statements and information contained in this application, my resume, and other documents or verbally obtained information obtained during an employment interview. I voluntarily consent to allow City of Caledonia, or any of their representatives or agents to check my references by contacting any persons, company or governmental entity they deem to be an appropriate reference. I understand that references questions may pertain to my personal or educational background, work experiences, character and behavior. I understand my employment is subject to satisfactory verification of this information and agree that deliberate falsification of this document or significant omissions shall be grounds for employment consideration disqualification or dismissal from employment if discovered at a later date. I pledge, if hired, to comply with the guidelines of conduct and company policies and procedures of City of Caledonia. I also realize that company policies, procedures, practices or statements made during an interview or employment do not create an employment contract by implication or otherwise. I further understand and agree that my employment is for no definite period of time and may, regardless of time and manner, be terminated by the company or myself with or without cause or previous notice. I understand that employment may be subject to satisfactory completion of a physical examination and/or drug screening.
I understand that, if hired, I am entering into a co-employment relationship whereas City of Caledonia is my worksite and directing employer, and City of Caledonia is my administrative employer. I agree that the benefit plans offered in my co-employment package are those of City of Caledonia and are the only benefit plans in which I am eligible to participate. I further agree that I will not be eligible for other benefits (if any) offered to other non co-employees of City of Caledonia, now or in the future. I understand, if hired, I may be required to sign a non-compete/non-disclosure agreement. This application will be kept in a current file for thirty days. If not contacted during that period of time, it may be necessary to complete another application to receive further employment consideration.

CAPTCHA

Employment

Employment Form

Reference 1

Reference 2

Reference 3

Education: High School

Education: Trade School

Education: College/University

Employment Experience

Employment 1

Employment 2

Employment 3

Applicant's Statement & Agreement

News & Updates