Employment Opportunities

Employment Experience
Beginning with the most recent/current, complete name and address of employer. Include military assignments and volunteer activities.
Employer 1
Employer Name
Address
Street Address City State ZIP Code
Position Title:
Summarize your duties:
Supervisor:
Reason for leaving:
Employment Start Date:
Employment End Date:
Salary:
May we contact this supervisor/employer?
- Yes
- No
Employer 2
Employer Name
Address
Street Address City State ZIP Code
Position Title:
Summarize your duties:
Supervisor:
Reason for leaving:
Employment Start Date:
Employment End Date:
Salary:
May we contact this supervisor/employer?
- Yes
- No
Employer 3
Employer Name
Address
Street Address City State ZIP Code
Position Title:
Summarize your duties:
Supervisor:
Reason for leaving:
Employment Start Date:
Employment End Date:
Salary:
May we contact this supervisor/employer?
- Yes
- No

Please read before signing.*
I certify that the foregoing answers are true and I authorize the companies and persons shown to give City of Fountain City any information they may have regarding me. I authorize investigation of my past employment, and release those persons, organizations, or companies supplying information from all liability and responsibility for any damages I may suffer as a result of this information. I understand that I must satisfactorily complete a physical examination and/or drug screen, if required for my position as a condition of employment. If employed, I agree to abide by all company regulations and policies. I also understand that any misrepresentation or false statement on this application will be cause for immediate dismissal.
- I have read the above agreement
Date
MM slash DD slash YYYY
Please attach a resume and resume cover sheet
Accepted file types: jpg, pdf, word, png, Max. file size: 64 MB.

City of Fountain City – Application for Employment