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Employment Application

  1. Equal Opportunity Employer. Incomplete applications will not be considered. Type “N/A” in any space that does not apply to you.

    The City of Boaz only accepts applications for open available positions that are listed on the Current Employment Opportunities page. Applications will not be accepted for future employment opportunities.

  2. Are you a citizen of the United States?

  3. If no, are you authorized to work in the U.S.?

  4. Are you willing to relocate to Boaz, Alabama?

  5. Have you ever been convicted of a felony?

  6. Did you graduate?

  7. Did you graduate?

  8. Did you graduate?

  9. Please list 3 professional references.

  10. May we contact your previous supervisor for a reference?

  11. May we contact your supervisor for a reference?

  12. May we contact your supervisor for a reference?

  13. Are you a Veteran?

  14. I represent and warrant that the information I have given on this application is full and true to the best of my knowledge. If I become an employee I understand that false, incomplete, or misleading statements on this application may be considered sufficient cause for dismissal. The use of this application does not in any way obligate the City. I understand that any offer of employment is contingent upon a satisfactory criminal background investigation. The Immigration Reform and Control Act of 1986 requires that, after employment, employers verify the legal work authorization and identity of all new employees. An offer of employment will depend upon the City's ability to verify this necessary information and a satisfactory pre-employment physical and drug screen. I give permission for my former employers and references to answer any and all questions based upon information available to them in my prior employment records. I release the City and all former employers from any liability as a result of this furnishing and receiving of this reference information. I understand that the City will attempt to verify statements made on my application and those made during my employment interview.

  15. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  16. This information is being requested in accordance with federal regulations. The information is voluntary and will not be used when considering you for employment with our company.

  17. Racial or Ethnic Group

  18. Gender

  19. Military Service

  20. Pursuant to S49-9-594, Code of Alabama 1975, the Alabama Criminal Justice Information Center (ACJIC) may supply employee criminal records and may provide the procedure for obtaining the records. The purpose of this waiver is to provide my employer/prospective employer with sufficient identifying information about myself to allow my employer/prospective employer to obtain my criminal record by querying the ACJIC Alabama Background Check (ABC) system.

    By signing this waiver ,I , certify that all of the personal identifying information provided herein is accurate. I understand that by providing this information and signing this document I agree to allow my employer/prospective employer to receive a copy of my report through ACJIC.

    I understand that ABC reports may contain reported felony and misdemeanor arrests, violations, and court records included in databases maintained by the State of Alabama. I further understand that ABC reports contain personal information from motor vehicle records included in records maintained by the State of Alabama. Personal information is information that identifies the individuals on whom the ABC report is conducted, including photograph, social security number, driver identification number, name, address, telephone number, and medical or disability information. Juvenile, youthful offender, sealed and/or expunged records will not appear on any ABC report.

    I further understand that any information supplied on an ABC report is derived from a name-based search using only the identifiers submitted by my employer/prospective employer or this employer's authorized Third Party user based on the information provided by me on this form. ACJIC in no way guarantees that criminal history record information provided through this system is for the person named in the request. Fingerprint based searches are the most reliable way to conduct criminal record checks and the least likely to result in either a false positive or false negative search result. This is not a fingerprint based search.

    I understand that this waiver may be sent to ACJIC electronically in a form prescribed by ACJIC.

    I understand that the results of my ABC report may be verified by submitting fingerprints to the Alabama Department of Public Safety.

  21. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  23. This field is not part of the form submission.