Online Employment Application

Employment Application

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THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT, but merely is intended to evaluate suitability for employment. It is the policy of the City of Moraine to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, national origin, citizenship, disability, veteran status, or any other status protected under local, state or federal law. It is also the policy of the City of Moraine to have the option of conducting pre-employment screenings before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a pre-employment drug screening and/or medical examination. This application will remain active for 6 months.

Personal Section

Position Applied for*

To review the published ad please click here

Name*

First Last

Date of Birth*

MM slash DD slash YYYY

Driver's License Number*

Email*

Phone (###) ###-####*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Education Section

High School*

High School Diploma*

High School City*

High School State*

Undergrad School

Undergrad School Diploma

Undergrad School City

Undergrad School State

Undergrad School Area of Study

Grad School

Grad School Diploma

Grad School City

Grad School State

Grad School Area of Study

Other School

Other School Diploma

Other School City

Other School State

Other School Area of Study

List Professional Designations

List Job Related Skills

Employment Section

Are you at least 18 years of age?*

Are you legally permitted to work in the United States?*

Do you have a valid driver's license?*

Have you worked for this City before?*

Have you reviewed the description of the job?*

Do you understand the job requirements?*

Have you ever served in the military?*

Are you on layoff and subject to recall?*

Are you currently bound by a noncompetition, confidentiality or trade secret agreement?*

Have you ever been discharged or asked to resign from a job?*

Have you been convicted of, or pled guilty to any traffic-related offense within the past five years?*

Have you had your driver's license suspended or revoked or had your driving privileges modified by a court of law?*

Employment History

May we contact your present/most recent employer?*

Employer*

Supervisor*

Phone (###) ###-####*

City*

State*

Position Held*

Held from*

MM slash DD slash YYYY

Held to*

MM slash DD slash YYYY

Duties*

Reason for Leaving*

Employer

Supervisor

Phone (###) ###-####

City

State

Position Held

Held from

MM slash DD slash YYYY

Held to

MM slash DD slash YYYY

Duties

Reason for Leaving

Employer

Supervisor

Phone (###) ###-####

City

State

Position Held

Held from

MM slash DD slash YYYY

Held to

MM slash DD slash YYYY

Duties

Reason for Leaving

References

Reference Name*

Reference Relationship*

Reference Phone (###) ###-####*

Reference Years Acquainted*

Reference Name*

Reference Relationship*

Reference Phone (###) ###-####*

Reference Years Acquainted*

Reference Name*

Reference Relationship*

Reference Phone (###) ###-####*

Reference Years Acquainted*

EOE

The City of Moraine is required to report on the statistical information requested below. Whether or not you elect to provide this information is entirely voluntary and will not affect any employment decision. However, in order for us to gather the needed information, we do ask that you provide responses to all 4 questions. If you prefer not to answer any or all of the following questions, please select “No Response”. Thank you for your assistance in this statistical survey.

Gender*

Age Group*

Ethnicity*

Do you have a known disability*

Security

1. The City of Moraine and other persons or employers are released from all liability brought forth by any investigation resulting from my submission of this electronic application and the data contained here in.

2. The information in this application is true and complete to the best of my knowledge. Any falsification, misrepresentation, or omission on this application can be cause for denial or termination of employment.

3. Upon acceptance of employment if a position is offered, I agree to abide by all existing and future company rules and regulations. The company reserves the right to change any working agreement as deemed necessary.

4. Any employment offer is contingent upon my providing proof of identity and eligibility to work in the United States.

5. I have read and reviewed the information provided in this application and the above statements. By signing this application for employment I certify that I understand all parts of it and have answered all questions completely and fully.

6. I understand that by typing my name in the signature box below and submitting this application electronically, this becomes a legal and binding contract.

Upload Cover Letter

50MB max, PDF only

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Accepted file types: pdf, Max. file size: 50 MB, Max. files: 1.

Upload Diplomas: all copies

50MB max, 3 files max, PDF only

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Accepted file types: pdf, Max. file size: 50 MB, Max. files: 3.

Upload Certifications: OPOTA, FF Level II, Paramedic, etc.

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Drop files here or

Accepted file types: pdf, Max. file size: 50 MB, Max. files: 3.