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Position Information

Which position are you applying for?*
Type of employment desired*
1. Full Time
2. Part Time
3. Internship
4. Seasonal
Salary Desired (if applicable)
Hours of work (per week) desired*
How did you hear about the position?
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Personal Information

First Name*
Last Name*
Address*
City*
State*
Zip*
Phone Number*
Email Address
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Supplemental Personal Information

Driver's License #
Expiration Date
State Issued By
Type of License
Have you ever been convicted of a violation of the law other than a minor traffic violation?
1. Yes
1. No
Are you 18 years old or older?
1. Yes
2. No
Have you ever had your license suspended or revoked?
1. Yes
2. No
Are you legally authorized to work in the United States?
1. Yes
2. No
How many traffic citations have you received in the last 5 years?
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Education

High School
Address / City
College
Address / City
Degree
Other
Address / City
Degree
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Certificates/Licenses

Certificate/License:
Issued By:
Date Expires:
Year Issued:
Add Another Certificate and/or License:
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Special Skills and/or Qualifications

List special qualifications and skills you posses which qualify you for the position you are applying.
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Preliminary Employment History

Employment History

(From Most Recent)
Company
Position
Address
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Responsibilities
Employed From - To (Date)
Salary
Company
Position
Address
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Responsibilities
Employed From - To (Date)
Salary
Company
Position
Address
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Responsibilities
Employed From - To (Date)
Salary
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References

Please list three professional references.
Full Name*
Relationship*
Company*
Phone Number*
Email Address*
Full Name*
Relationship*
Company*
Phone Number*
Email Address*
Full Name*
Relationship*
Company*
Phone Number*
Email Address*
Are you related to any member of the Saginaw City Council or any current City of Saginaw employee?
Please click one:
1. Yes
1. No
If "Yes", name of relative, relationship and/or Department:
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Upload Documents

Upload Your Resume
Upload Your Cover Letter (Optional)
Upload Authority for Release of Information and Waiver
Upload Authorization to Conduct Drug and/or Alcohol Testing
Upload Supplemental Work and personal History Form
Upload DPS Computerized Criminal History (CCH) Verification
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Disclaimer & Signature

Employment At-Will Statement
ln consideration of my employment, I agree to conform to the rules and regulations of the City of Saginaw, and my employment and compensation can be terminated with or without cause, and with without notice, at any time, at the option of the City or myself.
Drug-Free Work Environment:
The City of Saginaw is committed to providing a safe, efficient, drug-free environment for all employees. I understand that if I am offered employment with the City of Saginaw, I will be required to take a post-offer physical exam which will include drug testing. Any offer of employment that I may receive will be conditioned upon the results of the post-offer exam. In addition, positive results of the post-offer drug test will disqualify me from employment.
Applicant's Certification
I have reviewed the principle job duties and the minimum qualifications for the position for which I have applied. I am aware that this application will be subject to public disclosure unless an exception under the Texas Open Records Act is applicable. The information on this application is accurate to the best of my knowledge and is subject to verification by the City of Saginaw if so requested. I understand that the information provided by me herein may be used for the purpose of investigating my eligibility and my previous employers may be contacted. I agree that the City of Saginaw will not be liable for any damage which may result from the release of such information, and that any misrepresentation or deliberate omission in my application may be justification for refusal of, or termination of, employment with the City of Saginaw.
Applicant Signature*
Today's Date & Time*
Today's Date & Time
Today's Date & Time

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Position Information

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Education

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Special Skills and/or Qualifications

Preliminary Employment History

Employment History

References

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Disclaimer & Signature

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