Name*
Email*
Best Contact Phone Number*
Address*
Alternate Address
Date of Application*
Are you a United States citizen*
If you are not a United States citizen, are you authorized to work in the United States?
Are you at least 18 years old?*
If applying for police officer, are you at least 21 years of age?*
Have you ever been convicted, served a jail or prison sentence, or been placed on probation because of committing a felony or misdemeanor (other than a traffic violation or juvenile offense)?*
If you answered yes to the question above, please provide details below. (A criminal record will not necessarily exclude you from employment. Please give all facts so that an accurate decision may be made)
Have you ever been employed by the City of Farmington?*
If you answered yes to the question above, please provide the following. Date
Department
Position
Reason for Leaving
Have you ever been employed or attended school under any other names?*
If you answered yes to the above question, please list the name or names:
Do you have relatives working for the City of Farmington?*
If you answered yes to the question above, please list name and relationship:
Position(s) applying for:*
If an offer of employment is made, when would you be available for work?*
Are you currently employed?*
Name and Address of High School*
Diploma or Degree?*
Major / Subjects of Study?
Name and address of College
Did you receive a diploma or degree from college?
College Major / Subjects of Study?
Specialized training or trade school Diploma or Degree?
Name and address of specialized training, trade schools, etc.
Specialized training or trade school Major / Subjects of Study?
Name and address of other education
Other education Diploma or Degree?
Other Education Major / Subjects of Study?
Please list areas of highest proficiency, special skills, or other items that may contribute to your abilities in performing the above mentioned position.
Please list previous work history beginning from the most recent. Dates Employed
Previous Company Name
Previous Company Address
Previous Role/Title
Previous Salary
Previous Supervisor's Name and Telephone Number:
May we contact this previous employer?
Previous Job notes, duties, tasks performed, and reason for leaving:
2nd Previous Dates Employed
2nd Previous Company Name
2nd Previous Address
2nd Previous Role/Title
2nd Previous Salary
2nd Previous Supervisor Name and Telephone Number
May we contact this 2nd previous employer
2nd Previous Job notes, duties, tasks performed, and reason for leaving:
Are you a veteran of the U.S. Armed Services?*
If yes to the question above, list the branch and type of discharge:
Dates of service (From / To)
Rank at Discharge:
Reference #1 Name and Occupation*
Reference #1 Address*
Reference #1 Telephone Number*
Reference #2 Name and Occupation*
Reference #2 Address*
Reference #2 Telephone Number*
Reference #3 Name and Occupation*
Reference #3 Address*
Reference #3 Telephone Number*
Attach Resume*
