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2. Personal Information
4. Name
5. Email Address
7. Address
9. City
10. State
11. Zip Code
13. Phone Number
15. Have you ever been involuntarily terminated or requested to resign?*

    1. Yes

    1. No
16. If hired, can you provide verification of your legal right to work in the United States?*

    1. Yes

    1. No
18. Are you at least 18 years of age?*

    1. Yes

    1. No
19. Do you have a valid Florida driver's license?*

    1. Yes

    1. No
21. Are you able to perform the essential functions of the position as listed and described with or without a reasonable accomodation?*

    1. Yes

    1. No
23. Have you ever been convicted of a crime or been a defendant in a civil action for an internal tort?*

    1. Yes

    1. No
25. If yes, list offense, date, and disposition of the case.
27. Have you ever been employed by the City of Mascotte?*

    1. Yes
    2. No
29. Employment Interests
31. Position Desired*
32. Date Available*
    Date Available
33. Desired Salary*
34. Willing to work overtime?*

    1. Yes
    2. No
36. Education Information
38. School Level
    -- Select One --High School DiplomaCertificationAssociates DegreeBachelors DegreeMasters DegreeDoctorate Degree
39. Name of School
40. Major
41. Graduation Date
    Graduation Date
43. School Level
    -- Select One --High School DiplomaCertificationAssociates DegreeBachelors DegreeMasters DegreeDoctorate Degree
44. Name of School
45. Major
46. Graduation Date
    Graduation Date
48. School Level
    -- Select One --High School DiplomaCertificationAssociates DegreeBachelors DegreeMasters DegreeDoctorate Degree
49. Name of School
50. Major
51. Graduation Date
    Graduation Date
53. School Level
    -- Select One --High School DiplomaCertificationAssociates DegreeBachelors DegreeMasters DegreeDoctorate Degree
54. Name of School
55. Major
56. Graduation Date
    Graduation Date
58. Employment History

    Start with current/most recent employer

60. Company Name
61. City/State
62. Phone Number
63. Job Title
65. Start Date
    Start Date
66. End Date
    End Date
67. Starting Pay
68. Ending Pay
70. Company Name
71. City/State
72. Phone Number
73. Job Title
75. Start Date
    Start Date
76. End Date
    End Date
77. Starting Pay
78. Ending Pay
80. Company Name
81. City/State
82. Phone Number
83. Job Title
85. Start Date
    Start Date
86. End Date
    End Date
87. Starting Pay
88. Ending Pay
90. Company Name
91. City/State
92. Phone Number
93. Job Title
95. Start Date
    Start Date
96. End Date
    End Date
97. Starting Pay
98. Ending Pay
100. Additional Skills

     Any additional skills you feel are relevant to this position including languages spoken, computer skills, special training, etc.

102. Resume (Optional)
104. The State of Florida is classified as an employment at-will state meaning that the terms of employment may be changed with or without notice, with or without cause, including but not limited to termination, demotion, promotion, transfer, compensation, benefits, duties, and location of work. I acknowledged that my employment at the City of Mascotte (the City) is at-will. I have entered into my employment with the City voluntarily, and acknowledged that there is no agreement or contract, expressed or implied, between the City and me for continuing or long-term employment. While supervisors and managers have certain hiring authority, no supervisor or manager or representative of the City has any authority to alter the at-will relationship.*

     1. Yes
     2. No
106. I authorize any person, school, current employer (except as expressly noted), past employer(s), and organization, including consumer/credit reporting agencies to provide the City with relevant information and opinions, personal or otherwise, including access to and obtaining copies of personnel records that may be useful in making a hiring decision. I release all parties from all liability for any damage that may result from furnishing information and opinion to you.*

     1. Yes
     2. No
108. The contents of any employee handbook or personnel manuals, as well as other employer policies and practices, are subject to change or modification by the employer, solely at its discretion, without notice. I also understand that no supervisor or other official of the employer (except the City Manager, in writing) has the authority to enter into any agreement with me or make any agreement contrary to the foregoing.*

     1. Yes
     2. No
110. In consideration of employment, I agree to obey the policies, rules, and standards of the City. I understand that nothing contained in this application or in the interview process is intended to create a contract between the City and myself for either employment or for the providing of any benefits. I agree that my employment is at-will and the terms of employment may be changed with or without cause, with or without notice, including but not limited to termination, demotion, promotion, transfer, compensation, benefits, duties, and location of work, at any time, for any reason, at the option of myself or the City. This constitutes my entire agreement with the City with regard to the length of my employment.*

     1. Yes
     2. No
112. I understand that as a condition of my employment I may be required to complete a pre-employment background screening and/or a drug test. I further understand that, if management suspects that I am unable to perform my job without endangering others or myself at any time during my employment, I may be required to take an alcohol/drug test.*

     1. Yes
     2. No
114. I am able to perform the essential functions of the position with or without a reasonable accommodation.*

     1. Yes
     2. No
116. I understand that all offers of employment are conditioned upon my providing satisfactory documentation of my identity and legal right to work in the United States.*

     1. Yes
     2. No
118. I hereby acknowledge that I have read the above statements and understand them. I certify that I, the undersigned applicant, have personally completed this application. I declare that the facts contained in the application (or any resume or other documents submitted) are true and complete to the best of my knowledge. I understand that any misrepresentations or omissions will disqualify me from further consideration for employment, and will result in my dismissal from employment, if discovered at a later date.*

     1. Yes
     2. No

120. This employer is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, religion, national origin, disability, veteran status, citizenship status, or marital status. We assure you that your opportunity for employment with this employer depends solely on your qualifications.

122. Electronic Signature Agreement

     By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

     1. I agree.
124. Electronic Signature
Leave This Blank:


126. 1. Receive an email copy of this form.
127. Email address

     This field is not part of the form submission.

128. Submit

* indicates a required field