Employment Application ***NO OPEN POSIITONS AT THIS TIME*** Orange Vale Water Employment Application 2017.pdf EMPLOYMENT APPLICATION PERSONAL INFORMATION First Name (required) Middle Name (required) Last Name (required) Present Address Street (required) Present Address City (required) Present Address State (required) Present Address Zip (required) Past Address Street Past Address City Past Address State Past Address Zip Telephone Number (required) Email address (required) Are you 18 years of age or older? (required) Yes No EMPLOYMENT DESIRED Position (required) Date Available (required) Desired Wage (required) Type of employment desired (required) Full Time Part Time Specify Days Available (required) Sunday Monday Tuesday Wednesday Thursday Friday Saturday Specify Times Available: (required) Have you ever worked for this Company before? (required) Yes No If yes, please provide timeframe, location and name of supervisor EDUCATION Did you graduate from high school? (required) Yes No If “yes” provide the school name and location Complete the following for all education after high school (upload additional information if necessary) 1. Name and Location of School 1. Subjects Studied 1. Did You Graduate? 2. Name and Location of School 2. Subjects Studied 2. Did You Graduate? List Relevant Experience or Special Skills (required) Please upload any additional education information EMPLOYMENT HISTORY Describe all previous employment. Begin with your most recent employer. Do not omit any employer and describe the reason for any gaps in employment. (upload additional information if necessary) 1. Company Name/Address/Phone (required) 1. Start Date (required) 1. Start Salary (required) 1. Start Position (required) 1. End Date (required) 1. End Salary (required) 1. End Position (required) 1. Supervisor’s Name/Title (required) 1. Responsibilities (required) 1. Reason for Leaving (required) 2. Company Name/Address/Phone 2. Start Date 2. Start Salary 2. Start Position 2. End Date 2. End Salary 2. End Position 2. Supervisor’s Name/Title 2. Responsibilities 2. Reason for Leaving 3. Company Name/Address/Phone 3. Start Date 3. Start Salary 3. Start Position 3. End Date 3. End Salary 3. End Position 3. Supervisor’s Name/Title 3. Responsibilities 3. Reason for Leaving Please upload any additional employment information REFERENCES Identify two persons, not related to you, whom you have known for at least two years. 1. Reference Name / Address / Phone (required) 1. Reference Business/Occupation (required) 1. How Are You Acquainted? (required) 2. Reference Name / Address / Phone (required) 2. Reference Business/Occupation (required) 2. How Are You Acquainted? (required) New employees are required to produce verification of their legal right to work in the United States. If you are offered employment, can you produce documentation of your identity and right to work in the United States, and attest under penalty of perjury that the documents you produce are genuine and relate to you? (required) Yes No AGREEMENTS I authorize the investigation of all information provided in this application, information provided in the application process and in any supporting documents. I understand that falsification, misrepresentation or omission of facts will result in immediate dismissal or removal of my application from consideration. I authorize Orange Vale Water. to secure information about my background and experience from other employers, educational institutions, references and government agencies, and for those parties to provide information concerning my background and experience. I release all parties from any liability arising there from. If Orange Vale Water employs me, I agree to conform to the rules and regulations of Orange Vale Water I also understand and agree that, except for arbitration and employment at-will status, my wages, hours, working conditions, job assignments and compensation are subject to change by Orange Vale Water I understand my employment can be terminated, with or without cause and with or without notice, at any time at the option of Orange Vale Water or myself. I understand that, other than the President of Orange Vale Water, no manager, supervisor or representative of Orange Vale Water has authority to enter into any agreement for employment for any special period of time, or to make any agreement contrary to at-will employment. Only the President of Orange Vale Water has the authority to change my atwill status, and then only in a writing expressly changing my at-will status and expressly referencing and waiving these policies. (required) Yes No ACKNOWLEDGEMENT My signature below certifies that I have read and understand this application, and to the best of my knowledge, the information I provided is true and correct. My signature below also certifies that I agree to be bound by the terms and conditions of employment stated in this application, including at-will employment. This application contains all the understandings and agreements between me and Orange Vale Water concerning the nature of my employment, and supersedes all prior and/or contemporaneous practices, oral or written agreements, understandings, representations and promises, express or implied, between me and Orange Vale Water (required) Yes No Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures Orange Vale Water is an Equal Opportunity Employer It is Orange Vale Water’s policy to make all employment decisions without regard to an individual’s race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, military and veteran status, registered domestic partner status or any other basis made unlawful by applicable law. Orange Vale Water is an equal opportunity employer and selects employees on the basis of qualifications. Please contact the General Manager of Orange Vale Water if you have any questions or complaints regarding this policy There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
