Application Name:

_______________________________

Position Applied For:

_______________________________

Date: __________________________

Received
by: ____________________________

Quality of Life is our Commitment
Application for Employment
  Read the job announcement before you complete the application.
  Type or print clearly in dark ink.
  Complete all blanks; enter N/A if question does not apply.
  Make sure to include all experiance and training which might qualify you for the position for which you are applying.
  Attach resume as supplemental information if you wish.
  If you need more space for an answer, use an 8 1/2" x 11" size sheet of paper. Write your name and position title in the upper left hand corner of the attachment.
  If you do not answer all questions fully and correctly, you may delay the review of your applications and lose job opportunities.

 

 

 

 

 

 

 

 

 

 

 

 


Application for Employment

We consider applications for all postions without regard to race, color, religion, creed, gender, national orgin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.


INSTRUCTIONS

Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. Use blank paper if you do not have enough room on this application. Except for the signature at the end of application. You may also attach a resume' and cover letter if you desire.

PLEASE PRINT
Name: _____________________________ Telephone Number: ____________________________

Address: _________________________ City: _______________________ State:____________________

Zip Code: ______________ Email: _____________________________________

Position(s) Applied for                                                                    Date of Application
_______________________________________________________________________________________

How did you learn about us?
Advertisement                    Friend                   Walk In               Employment Agency
Relative                             Other____________________________________________


If you are under 18 years of age, can you provide required proof
of your eligibility to work? 
Yes No
For Sworn Police postitions only: Are you 21? Yes No
Have you ever been employed or educated under another name?

If yes, please state name(s) ______________________________________

Yes No
Have you ever filed an application for employment or been
employed here before?
If yes, please state date(s) _________________________

Yes No
May we contact your current employer? Yes No
Have you been convicted of a felony within the last 7 years?
Conviction will not necessarily disqualify an application from employment.

Yes No
If yes, please explain:_________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
   
     

 

 

 


EDUCATION

School Name & Location of School Course of Study Years of Study Degree
Graduate


       
College


       
Business/Trade/
Technical



       
High School


       
Other 


       

TRAINING

If you have completed any other courses or training related to the job posting, please indicate below.
Month/Year
Training
Completed
Total Classroom Hours Course Title Name/Location of
School/Training
Facility
(City/State)
Certificate/Diploma
(if any)

 

 

       

 

 

       

 

 

       

MILITARY AND VETERANS INFORMATION

Military Service Veterans Preference
(dates and branch of all active service): If preference eligible you must attach a copy of your DD214 and SF-15

 

 

 

 

Describe any job-related training received in the United States Military.

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________


WORK EXPERIENCE

This is a very important part of the application. Neglecting to provide all the information requested could cause you to be disqualified for the position. The application form asks you to describe duties, responsibilities and accomplishments. Duties are what you do for your employer. Responsibilities involve some independent thought and judgment on your part.
Accomplishments are what you have done that are above and beyond what is normally expected of you.
Describe your current or most recent position in the first box and work backwards, describing each position you have held. (List all part-time employment information.) If you need additional space, please continue on a separate sheet of paper. A resume may also be attached in addition to providing the information requested below.
Employer
___________________________________________
Telephone
(____)____________________
Address
___________________________________________
Employed - Month & Year
From_________________ To __________________
Name of Supervisor
___________________________________________
Weekly pay
Start _________________ Last ________________
Job Title & Describe Your Work
___________________________________________

___________________________________________
Reason for Leaving
___________________________________________

___________________________________________
Employer
___________________________________________
Telephone
(____)____________________
Address
___________________________________________
Employed - Month & Year
From_________________ To __________________
Name of Supervisor
___________________________________________
Weekly pay
Start _________________ Last ________________
Job Title & Describe Your Work
___________________________________________

___________________________________________
Reason for Leaving
___________________________________________

___________________________________________
Employer
___________________________________________
Telephone
(____)____________________
Address
___________________________________________
Employed - Month & Year
From_________________ To __________________
Name of Supervisor
___________________________________________
Weekly pay
Start _________________ Last ________________
Job Title & Describe Your Work
___________________________________________

___________________________________________
Reason for Leaving
___________________________________________

___________________________________________
Employer
___________________________________________
Telephone
(____)____________________
Address
___________________________________________
Employed - Month & Year
From_________________ To __________________
Name of Supervisor
___________________________________________
Weekly pay
Start _________________ Last ________________
Job Title & Describe Your Work
___________________________________________

___________________________________________
Reason for Leaving
___________________________________________

___________________________________________
We May contact the employers listed above unless you indicate those you do not want us to contact.
DO NOT CONTACT _______________________________________________________________________
Reason : __________________________________________________________________________________

 

REFERENCE

List three to five people not related to you, who have known you for at least one year and who know your qualifications and fitness for the job for which you are applying. Do not list supervisors you listed in the Work Experiance area.
Full Name of Reference Present Business or Home Address-(Number, Street, City,Zip Code) Telephone Number(s) (Include Area Code)

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

APPLICANT'S STATEMENT
I certify that answers given herein are true and complete to the best of my knowledge.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 30 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "all will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledge in writing by an authorized executive of this organization.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer and does not grant me any right of continued employment and does not establish or create a contract of employment, either express or implied, between the City of Montose and me.
                          ____________________
Signature
______________
Date Signed


 


POLICE OFFICER
SUPPLEMENTAL
APPLICATION

Name(Last, First, M.I.) SSN#:

Colorado law requires POST certification in order to be considered for this position. Do you posses current, valid POST certification?   Yes   No   Date of certification (Month/Year): ____________________

Certificate Number:____________________________
You must attach a copy of your Colorado certification form to this application. Failure to provide this information may result in disqualification..

Are you enrolled in an academy or taking the test that will result in attainment of Colorado POST certification?

Yes    No   By what date? _____________________________

If you need information on the POST certification program, please call POST at 303-866-5692. POST should also be able to address certification issues for out-of-state candidates.

Colorado law requires that eligible candidates be high school graduates or have a GED equivalent.
Cannot have been convicted of a felony or a misdemeanor involving moral turpitude or domestic violence.

Please respond to each of the following questions-- Yes or No:
Are you a United States Citizen?

Yes
No
Are you at least 21 years of age?

Yes
No
Do you possess current, valid American Red Cross?

Yes
No
Standard First Aid and CPR certifications?

Yes
No
Do you possess or can you obtain a valid Colorado drivers license?

Yes
No
You must attach copies of your First Aid and CPR certifications to this application. You must submit a copy of your driving record dated on or after May 29, 1997 (obtain from DMV). Failure to provide this information may result in disqualification.

Please describe any experience you have had using computers for data entry, word processing, and/or spreadsheets including the type of computer, type of software, and the work you performed on the computer. Be sure to indicate if you have used Word Perfect, MS Word or Lotus (especially with Windows):

_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
SIGNATURE:

DATE SIGNED (Month,Day,Year):

Colorado State Logo Colorado Department of Law Misdermeanors which will Affect Certification:
Colorado Revised Statute
Cite
Yes
No
Initials
18-3-204
Assault in the third degree
18-3-402
Third degree sexual assault
18-3-404
Unlawful sexual contact
18-3-405.5
Sexual assault on a client by a psychotherapist
18-3-412.5
Sex offenders - duty to register - penalties
18-7-201
Prostitution prohibited
18-7-202
Soliciting for prostitution
18-7-203
Pandering
18-7-204
Keeping a place of prostitution
18-7-302
Indecent exposure
18-7-601
Dispensing violent films to minors
18-8-102
Obstructing government operations
18-8-103
Resisting arrest
18-8-104
Obstructing a peace officer, firefighter, emergency medical services provider, rescure specialist, or volunteer
18-8-108
Compounding
18-8-109
Concealing death
18-8-111
False reporting to authorities
18-8-112
Impersonating a peace officer
18-8-113
Impersonating a public servant
18-8-114
Abuse of public records
18-8-201
Aiding escape
18-8-204.2
Possession of contraband in the second degree
18-8-208
Escapes
18-8-208.1
Attempt to escape
18-8-212
Violation of bail bond conditions
18-8-304
Soliciting unlawful compensation
18-8-305
Trading in Public office
18-8-308
Failing to disclose a conflict of interest
18-8-403
Official opperssion
18-8-404
First degree official misconduct
18-8-503
Perjury in the Second degree
18-8-611
Simulating legal process
18-8-612
Failure to obey a juror summons
18-8-613
Willful misrepresentation of material fact on juror questionnaire
18-8-614
Willful harassment of juror by employer
18-8-802
Duty to report use of force by peace officers
18-9-111
Harassment
18-9-121
Ethnic intimidation
18-18-404
Unlawful use of controlled substance
18-18-405
Unlawful distribution, manufacturing, dispensing, sale, or possession of a controlled substance
18-18-406
Offenses relating to marihuana and marihuana concentrate
18-18-411
Keeping, maintaining, controlling, renting, or making available property for unlawful distribution or manufacture of controlled substances.

Last modified June 29, 2001

 

Authorization to Work in the United States:

On November 5, 1986, the Immigration Reform and Control Act was signed into law making employment of unauthorized aliens unlawful. The Act requires every employer to examine and verify certain documents that establish the employment eligibility of all employees hired after November 6, 1986. For each employee hired after this date, the City must keep on file a form confirming that the City examined appropriate documents for each new employee. If you are selected for the position for which you applied, you must provide the appropriate documents to the Personnel Department before you can be hired. Please be prepared to bring with you the following Document(s):

 

One document of the following establishing both identify and employment authorization:
     a. U.S. Passport or
     b. Certificate of U.S. Citizenship or Naturalization or
     c. Alien Registration Card (a.k.a. "Green Card") or

     e. Unexpired Foreign Passport with Valid Work Authorization.

 

OR
One document of the following establishing identity:
     a. Drivers License or
     b. State-issued ID Card with photograph or
     c. School ID Card with photograph
AND

One document of the following establishing employment authorization:
     a. Social Security Card or
     b. U.S. Birth Certificate (issued by state or county entity; certificates issued by hospital are not          acceptable.)

 

COMPLETED APPLICATIONS AND ALL ATTACHMENTS MUST BE RECEIVED IN THE HUMAN RESOURCE DEPARTMENT BY THE DEADLINE INDICATED ON THE JOB ANNOUNCEMENT. APPLICATIONS RECEIVED AFTER THE DEADLINE WILL NOT BE CONSIDERED.

 

Return by mail to:
Hand deliver to:
City of Montrose
Human Resource Department
P.O. Box 790
Montrose, Colorado 81401-0790
City of Montrose
433 South 1st Street
Montrose, Colorado