Employment Application

Job Application

1. Job Applied for Choose an open position. Jailer - Sheriff's Office
2. Date Available

Personal Information

1. First Name
2. Middle Name
3. Last Name
4. Email
5. Phone
6. Alternate Phone
7. Address
8. City
9. State Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
10. Zip

Background

1. Are you a U.S. Citizen? Please Select Yes No
2. Are you prevented from lawfully becoming employed in this country because of Visa or immigration status? Please Select Yes No
If yes, please explain.
3. Have you ever been convicted of a felony?
   For purposes of these questions, convicted includes plead guilty, plead no contest, or been given a deferred sentence of judgment. Please Select Yes No
If yes, please explain.
4. Have you interviewed with the County in the past 12 months? Please Select Yes No
If yes, which position(s)?
5. Have you ever been employed by Guthrie County? Please Select Yes No
Employed Start Date:
Employed End Date:
Employed Position
Reason for Leaving
6. Are you related to anyone who works for Guthrie County? Please Select Yes No
If yes, please list the relative(s) and describe the relationship.
7. If you have a valid driver's license, please select the type below. Please Select None Regular A B CDL

Education

High School

1. Name and Location
2. Did you Graduate? Please Select Yes No No, but received GED

College or Trade School

1. Name and Location
2. Did you Graduate? Please Select Yes No
3. Major/Subject

Graduate/College

1. Name and Location
2. Did you Graduate? Please Select Yes No
3. Major/Subject
4. Describe any specialized training, apprenticeship, skills, and/or extracurricular activities.

Employment History

List employment from the past 10 years, starting with your most recent job. Account for any time period that you were unemployed by stating the nature of your activities.

Employer 1

1. Employer Name
2. Address
3. City
4. State Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
5. Zip
6. Phone
7. Job Title
8. Supervisor Name
9. Start Date
10. End Date
11. Work Performed
12. Reason For Leaving
13. Can we contact current employer? Please Select Yes No
Add Employer

Optional: Upload Resume and Cover Letter

1. Resume
   only PDF files are allowed
2. Cover Letter
   only PDF files are allowed

References

Please list three personal references, other than prior employers or relatives, whom we can contact.

Reference 1

1. Name
2. Phone
3. How long have you known this reference?
4. Occupation

Reference 2

1. Name
2. Phone
3. How long have you known this reference?
4. Occupation

Reference 3

1. Name
2. Phone
3. How long have you known this reference?
4. Occupation

Military Service Record

1. Have you ever served in the armed forces? Please Select Yes No
Branch
Rank Discharge: List your duties in service, including special training.
Any person who may wish to claim a Veterans Preference must submit a copy of a certified form DD214 by the deadline set for the receipt of applications for the position for which the person is applying.
Upload DD214 Form
only PDF files are allowed
Attention: Applicants having military experience should also read and sign the following statement: I authorize the National Personnel Records Center, St Louis, MO or other custodian/s of my military record to release to the Guthrie County Personnel Board, information or photocopies form my military personnel and related medical records, or only the following informational records.
Signature Please type your full name to serve as an electronic signature.

Authorization and Release

Please read carefully before signing.

Guthrie County is an equal opportunity employer. Guthrie County does not discriminate in employment based on race. color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, veteran status or physical or mental disability.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Guthrie County to hire me. If I am hired, I understand that either Guthrie County or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Guthrie County has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Guthrie County true and complete information on this application. No requested information has been concealed. I authorize Guthrie County to contact references and verify the information I have provided. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Your Signature

1. Signature Please type your full name to serve as an electronic signature.
2. Today's Date