test form | Toombs County Sheriff

PRE-EMPLOYMENT APPLICATION

Pre-Employment Questionnaire: An Equal Opportunity Employer

Detention Division Application for Employment

Personal Information Name *

SOCIAL SECURITY NUMBER *

CURRENT ADDRESS *

PERMANENT ADDRESS

If different than current address

PHONE NUMBER *

SECONDARY PHONE NUMBER

Referred by: *

Position Applied For *

Date You Can Start *

Salary Desired *

Are You Employed Now? *

If so may we inquire of your present employer? *

Have you applied here before? If so, when? *

EDUCATION HISTORY

Answer the following questions about your education

EDUCATION HISTORY Name and location of high school. Years Attended *

Did you graduate? *

Yes or No

Subjects Studied *

List other high Schools attended if applicable.

Name and location of college and years attended.

Did you graduate?

List Major and Minor And Subjects Studied

Name and location of Trade, Business, or Correspondence School

Years Attended. Did You Graduate?

Subjects Studied

List Any Subjects of Special Study Or Research Work

US Military Service Or Naval Service

If so, list your rank

List Your Last Four Employers, Beginning With The Last One First Employer 1 Name and Address *

Employer 1 List Dates Employed *

Employer 1 Salary and Position *

Employer 1 Reason for Leaving? *

Employer 2 List Name and Address *

Employer 2 Dates Employed *

Employer 2 Salary and position *

Employer 2 Reason for leaving *

Employer 3 Name and Address *

Employer 3 Dates Employed *

Employer 3 Salary and position *

Employer 3 Reason for leaving *

Employer 4 Name and Address *

Employer 4 Dates Employed *

Employer 4 Salary and position *

Employer 4 Reason for leaving *

REFERENCES List 3 people you have known at least one year that you are not related to. Please include Name, Address, Occupation, and Years known. Reference 1 *

Reference 2 *

Reference 3 *

What is your email address? *

Authorization "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment." In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.Write Your Signature and Date *

ELIGIBILITY VERIFICATION DOCUMENT FORM UPON HIRE. Criminal History Record Information Consent/Inquiry Form *

INITIAL HERE

I hearby give consent to the Toombs county sheriff department to receive any Georgia and all criminal history record information pertaining to me, as authorized under state and federal law for individuals seeking employment with a criminal justice agency. *

INITIAL HERE

Enter Full Name *

Email *

Address *

Sex *

Race *

Phone *

Date of Birth *

Social Security Number *

Initial here for 90 days. *

This authorization is good for 90 days. Yes or No

Initial here for 180 days. *

This authorization is good for 180 days. Yes or No

I hearby give consent to the above named to perform periodic criminal history backgound check for the duration of my employment with this agency. Electronic Signature *

Type your full name as your signature.