Application for Employment

We appreciate your interest in employment with the City of Salisbury. The information requested in this application will aid us in evaluating your qualifications. Qualified applicants are considered without regard to race, color, religion, sex, national origin, age, marital or veteran status, sexual orientation, genetic information or presence of a medical condition or handicap.

If you require a physical application, contact us at [email protected]

Application for Employment

Step 1 of 7

Position for which you are applying*
Additional position(s) for which you are applying
Please complete if applying for more than one position
Name*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Phone*
Secondary Phone
Email*
Date available to work*
MM slash DD slash YYYY
Lowest pay you will accept*
Are you legally authorized to accept work and remain in the United States?*
- Yes
- No
(Proof of identity and authorization will be required upon employment)
Are you currently 18 years of age or older?*
- Yes
- No

Education and Training
Grade School*
Select the highest grade completed
High School*
Select the highest grade completed. NOTE: If you select "4 (Senior)," you are affirming that you graduated high school.
High School Name
Please indicate the name of the high school from which you graduated. If you did not graduate, indicate the name of the high school which you last attended.
City and State of High School
City State / Province / Region ZIP / Postal Code
Do you have a G.E.D. or equivalent?
- Yes
- No
College/University
Select the highest grade completed.
City and State of College or University
City State / Province / Region ZIP / Postal Code
Grad School
Select the highest grade completed
City and State of Grad School
City State / Province / Region ZIP / Postal Code
List any additional training and/or education completed
References
List three (3) persons who are not related to you and who have knowledge of your qualifications. NOTE: If you list a former supervisor here, you will not be allowed to list them again later in this application. Duplicate names will not be accepted.
Name Address Phone
Name Address Phone
Name Address Phone
Name Address Phone

Experience
Starting with your current or most recent job, list all positions you have held in the last ten (10) years. If you consider it appropriate to this application, you may include, as an addendum, positions held earlier than ten years ago. Be concise, but do not omit information which may be relevant to the position for which you are applying.
Previous Employer 1
Previous Job Information
Company Name Position Held/Job Title Hrs. Per Week

Number of Persons Supervised Name of Supervisor

Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone
Dates of Employment
List your start and end dates. If you still have the position, type "Present" in the "To" field.
From: To:

Reason for Leaving
May we contact this employer?
Yes
No
If you prefer that we NOT contact this employer, please explain why not.
Previous Employer 2
Previous Job Information
Company Name Position Held/Job Title Hrs. Per Week

Number of Persons Supervised Name of Supervisor

Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone
Dates of Employment
List your start and end dates. If you still have the position, type "Present" in the "To" field.
From: To:

Reason for Leaving
May we contact this employer?
Yes
No
If you prefer that we NOT contact this employer, please explain why not.
Previous Employer 3
Previous Job Information
Company Name Position Held/Job Title Hrs. Per Week

Number of Persons Supervised Name of Supervisor

Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone
Dates of Employment
List your start and end dates. If you still have the position, type "Present" in the "To" field.
From: To:

Reason for Leaving
May we contact this employer?
Yes
No
If you prefer that we NOT contact this employer, please explain why not.
Previous Employer 4
Previous Job Information
Company Name Position Held/Job Title Hrs. Per Week

Number of Persons Supervised Name of Supervisor

Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone
Dates of Employment
List your start and end dates. If you still have the position, type "Present" in the "To" field.
From: To:

Reason for Leaving
May we contact this employer?
Yes
No
If you prefer that we NOT contact this employer, please explain why not.
Additional Employment History
If you require more space to list previous employers/employment history, you may either:

1.) Enter the information in the blank field below, or

2.) Upload a Word document or Adobe PDF document using the "Upload" tab below.
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Max. file size: 256 MB.

Military Service
Have you ever served in the United States Armed Forces?*
If yes, which branch?*
Serial or Service Number*

Service Dates*
From To

Does your military service have any relationship to the position for which you have applied?*
Yes
No
If yes, please explain*

Additional Information
Are you related by blood or marriage to any City employee(s)?*
Yes
No
If yes, please complete the following:
Name Department Relation

Name Department Relation

Name Department Relation

Have you been employed with us before?
Yes
No
If yes, please answer the following:
Position Start Date End Date

Reason for Leaving
How did you hear about this job?
If "other," please elaborate*
Are you able to perform ALL of the duties and meet ALL of the requirements as listed in the job ad for the position for which you are applying with or without accommodations?*
Yes
No

Upload your cover letter
Max. file size: 256 MB.
Upload your resume
Please use this field to upload your resume
Max. file size: 256 MB.
Upload your references
Max. file size: 256 MB.
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Terms and Legal Information
Please read below and indicate your acceptance by clicking the box at the bottom. You're almost done!
PLEASE READ CAREFULLY*
a. Under Maryland law an employer may not require or demand any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of employment or continued employment, except law enforcement officers as defined in 727 of Article 27, or any employee of any law enforcement agency of the State of Maryland, or any county incorporated city or town, or other municipal corporation. Any employer who violates this provision is guilty of a misdemeanor and subject to a fine not to exceed $100.

b. In submitting this application for employment, I authorize investigation of all statements contained therein. I hereby authorize the City of Salisbury to make any contacts considered necessary to my employment, such as previous employers, criminal or credit bureau records. I authorize any person or organization whose name I have given as a character reference or by whom I have been previously employed and any educational institution which I have stated I attended to furnish the City any information they may have concerning me. I hereby release all such persons, organizations, and institutions from any claims for damages or otherwise by reason of furnishing such information and records. It is understood and agreed that any misrepresentations or omissions by me in this application will be sufficient cause for cancellation of the application or the separation from City employment.

c. I understand that as a condition of employment, I may be required to undergo and successfully pass a screening for substance abuse. I also understand and agree that, if employed, I may be required to submit to an alcohol or substance abuse screening as required by law and City Policies and Procedures. I hereby consent to having the results of any such alcohol or substance abuse screening I may be required to undergo disclosed to City Government. I understand that this application is the property of City Government and will be part of my personnel file if I am accepted for employment. Driving record checks may be required of an applicant or employee who may be required to operate a City or personal vehicle on City business. This will also depend on the nature of the position and the insurance company's requirements. I hereby authorize the City to obtain a complete driving history.

d. Any applicant who is selected for employment by the City of Salisbury must, as a condition of employment and before any offer of employment can be considered final, complete United States Department of Justice Immigration and Naturalization Service Form I-9 and provide acceptable documents that establish both identity and employment authorization as defined by Federal Regulation. The foregoing must be accomplished before employment and failure to do so will cancel any offer of employment with the City of Salisbury. The proposed employee has 5 working days within which to comply with these requirements.

I have read the terms above, and I understand
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Phone
This field is for validation purposes and should be left unchanged.

Type of License	License Number	Expiration Date

Application for Employment

Step 1 of 7

Education and Training

Experience

Previous Employer 1

Previous Employer 2

Previous Employer 3

Previous Employer 4

Additional Employment History

Military Service

Additional Information

Section Break

Terms and Legal Information