City of Enid Employment Application

Application ID
Items marked with * are required.

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Referral Source:  
Newspaper    Employment Agency    Professional Journal/Newsletter
Current Employee    Friend/Relative    Walk-In    Community Organization
Job Fair    City of Enid Website    Other Internet Site
 
* Last Name * First Name  
 
Middle Name Other Names (Under which you have been employed)    
   
* Street Address * Home Phone    
   
* City/State/Zip Alternate Phone    
   
* Position Desired * Date    
   
* Date available to work  * Social Security Number (Read E-Verify Notice)  
 
* Birthdate Email Address  
 
Are you available to work: Full Time Part Time Days Weekends Nights
* If you are under 18 years of age, can you provide proof of your eligibility to work? Yes   No
Have you ever worked for the City of Enid before? Yes  No
If yes, give prior name, department, dates and reason for leaving:  
(Maximum characters: 50)
You have characters left.
 
* Are you legally eligible to work in the United States? Yes No  
* Do you require sponsorship for an employment visa? Yes No  
* Do you have a current Oklahoma Drviver's License? Yes No  
Do you have a CDL? A B C  
* Are you related to any city employee or any member of the City Council? Yes No  
If yes, give name, department, and relationship.  
 
* Have you been convicted, plead guilty, nolo contendo to any crime in the last 7 years? Yes No  
If yes, list charge and list date .  
(Maximum characters: 75)
You have characters left.
 
(Note: This information does not necessarily disqualify you for employment.)
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Beginning with your most recent employment, list all positions held.

 
Company 1 Information
Company Address  
 
City/State/Zip    
   
Start Date End Date  
 
Title Ending Salary  
 
Responsibilities  
(Maximum characters: 100)
You have characters left.
 
Your immediate supervisor's name Supervisor's Title  
 
Supervisor's Phone    
   
Why did you leave?  
 
May we contact as a reference? Yes No  
Company 2 Information
Company Address  
 
City/State/Zip    
   
Start Date End Date  
 
Title Ending Salary  
 
Responsibilities  
(Maximum characters: 100)
You have characters left.
 
Your immediate supervisor's name Supervisor's Title  
 
Supervisor's Phone    
   
Why did you leave?  
 
May we contact as a reference? Yes No  
Company 3 Information
Company Address  
 
City/State/Zip    
   
Start Date End Date  
 
Title Ending Salary  
 
Responsibilities  
(Maximum characters: 100)
You have characters left.
 
Your immediate supervisor's name Supervisor's Title  
 
Supervisor's Phone    
   
Why did you leave?  
 
May we contact as a reference? Yes No  
Company 4 Information
Company Address  
 
City/State/Zip    
   
Start Date End Date  
 
Title Ending Salary  
 
Responsibilities  
(Maximum characters: 100)
You have characters left.
 
Your immediate supervisor's name Supervisor's Title  
 
Supervisor's Phone    
   
Why did you leave?  
 
May we contact as a reference? Yes No  
Please explain all periods of no employment.
(Maximum characters: 100)
You have characters left.
Please list any experiences, skills, or qualifications you possess which may be applicable to the position.
(Maximum characters: 100)
You have characters left.
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* Select your highest grade completed?
High school  
6 7 8 9 10 11 12  
College  
1 2 3 4  
Post Graduate  
1 2 3 4  
College Attended    
   
College Major    
   
Degree or Credit Hours  
 
Other Training  
 
Keyboarding Words Per Minute (WPM)  
 
Software Proficiency    
   
Business Machines    
   
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Were you in the U.S.Armed Forces? Yes No
What Branch?    
   
Total Years    
   
Date of Duty: from mo/yr Date of Duty: to mo/yr    
   
List duties in service, including special training.  
(Maximum characters: 70)
You have characters left.
 
 
Give name, address and telephone number of at least three references who are not related to you. Please include at least two previous employer/professional references.
Name & Title Address Phone
 
 
 
Release & Consent for a National Criminal History Check
I certify that all answers given on my application are true to the best of my knowledge. I authorize the investigation of all matters contained in my application and hereby give the City of Enid and its consumer reporting agency, Sentry Link, Pre-Hire, and/or ADP Screening and Selection Services, permission to contact appropriate parties, and hereby release employer and its agent from all liability as a result of such contact. I hereby consent to allow the consumer reporting agency to conduct a National Criminal History Check on me, and to report the results of such a check to the City of Enid. I understand and authorize the release of such information to the City of Enid, Sentry Link, Pre-Hire, and ADP Screening and Selection Services.

I agree that the City of Enid may, at its sole discretion, deny me employment, if the information received in the National Criminal History Check is considered unfavorable by the City of Enid. Any offer of employment by the City of Enid is subject to and conditioned upon the City of Enid's review of such information.

In the event of an offer of employment, subsequent employment, or continuing employment, I understand that false, misleading or omitted information in my application shall be grounds for withdrawal of an offer of employment or discharge at any time.
Notice to Applicant regarding consumer rights under the Fair Credit Reporting Act:
The Fair Credit Reporting Act (FCRA) governs the activities of consumer credit reporting agencies, as well as the users of the information procured from these agencies. A consumer report contains information on a consumer’s (job applicant’s) character, reputation, and other personal data. To screen job applicants, employers procure these reports. The City of Enid agrees to comply with all aspects of the Fair Credit Reporting Act and any applicable Federal or State equal employment opportunity laws or
regulations.

Among other things, the FCRA prohibits employers from obtaining consumer reports unless the Employer discloses to the applicant, in writing, that such a report may be acquired (see attachment). This disclosure must be in the form of a document that consists solely of the disclosure that a consumer report may be obtained for employment purposes. This release must also state that if the employer denies employment based on the information from a consumer reporting agency, the applicant may make a
written inquiry requesting a disclosure of the nature and scope of the investigation.

If an applicant makes such a request, the consumer reporting agency will supply a complete and accurate disclosure of the nature and scope of the investigation within five days of the request. The credit reporting agency will reexamine any item the applicant holds to be incorrect at no additional charge and, if necessary, supply a corrected report to the original requester. The consumer reporting agency keeps copies of an investigation for a period of not less than one year.

If a consumer reporting agency or user of such information willfully fails to comply with FCRA requirements, the agency and its agents are responsible to the subject of the report. The agency must comply with all regulations set forth by the FCRA.

In addition, any individual who knowingly and willfully obtains information from a consumer reporting agency under false pretenses will be fined not more than $5000.00 and imprisoned not more than one year or both.

Sentry Link, Pre-Hire and ADP Screening and Selection Services comply with and support all provisions of the Fair Credit Reporting Act (FCRA). We urge all employers and applicants to review its restrictions and requirements. The Act’s citation is Public Law 91-508, Title 15, U.S.C. Sections 1681, et seq. Please note, particularly the Permissible Purposes of Reports, as well as requirements on Users of Consumer Reports and Obtaining Information Under False Pretenses.

By my initials below, I certify that I have read this release and consent form and understand all of its terms. I execute it voluntarily and with full knowledge of its significance.
Initial  
Rights of Applicant Under the Substance Abuse Policy for the City of Enid
As an applicant who has been offered a position with the City of Enid, I have been asked to give the City a urine sample for drug testing under the substance abuse policy. I have the following rights:
  1. I may refuse to provide the City with the appropriate sample. However, if I refuse, it may result in the City rescinding its offer of employment.
  2. If I agree to give a urine sample for testing, I will be asked to sign a consent form which authorizes the taking and sending of the sample to the laboratory used by the City to conduct the analysis and to release said results of the analysis to the medical review officer and to the designated Substance Abuse Policy Administrator for the City of Enid.
  3. If I agree to be tested, I will be required to report to a medical facility within forty-eight (48) hours of the offer of employment. If positive, I will not be eligible for employment with the City of Enid.
  4. I may, within seventy-two (72) hours of receipt of a positive drug test result, request the specimen be analyzed by a different certified laboratory site. If I request the second specimen test, I will be responsible for its cost, unless the second test result is negative.
  5. I acknowledge that I have read the following City of Enid’s Substance Abuse Policies.
Substance Abuse Policies: AFSCME, FOP, IAFF, EPTA
By my initials below, I certify that on this day of , I have read the foregoing rights and fully understand them. I execute it voluntarily and with full knowledge of its significance.
Initial  
City of Enid Medical Consent and Release of Information

The undersigned voluntarily consents and agrees to submit to medical examination and tests, which may include a physical examination, urine test for controlled substances, and/or evidential breath or blood
alcohol test by doctors or other qualified persons.
The results of any such examination and tests may be released to the City of Enid, Oklahoma, or any of its authorized agents, representatives, or employees.
By my initials below, I certify that I have read the foregoing rights and fully understand them. I execute it voluntarily and with full knowledge of its significance.

Initial  
I agree and understand that the City of Enid supports the Drug Free Workplace Act of 1988. To promote a work environment free from the effects of drugs, all job applicants will undergo screening for the presence of illegal drugs as a condition of employment.
It is the policy of the City of Enid to provide reasonable accommodations for qualified persons with disabilities who are employees or applicants for employment. If you need assistance or accommodations to fully participate in the interview process, please contact The Human Resource Department or City ADA Coordinator.
 
"By entering my name below, I acknowledge that I have read and understood the above statements. I certify that the information listed on this application is true and accurate to the best of my knowledge."
Signature  
 
Affirmative Action Survey (Optional)
Government agencies require periodic reports on the sex, ethnicity, handicapped and veteran status of applicants. This data is for analysis and affirmative action only. Submission of information is voluntary. This information will be kept in a Confidential File separate from the Application for Employment.
Gender Classification:   Male   Female
Race/Ethnic Group: White      Black      Hispanic
                                American Indian/Alaskan Native      Asian/Pacific Islander
Check if any of the following are applicable:   Disabled Veteran   Handicapped Individual
Birth Date:   
 
 
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