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Application For Employment

  1. Header

  2. Personal Data

  3. Best times to be reached

  4. Best time to be reached

  5. Note: If offered employment you will be required to provide documentation to verify employment eligibility. Failure to provide the requested documentation may result is a determination that the applicant is ineligible for employment in the United States

  6. If yes, when and where?

  7. If an accommodation is needed, how would you perform the job duties, and with what accommodation(s)

  8. If yes please provide License # Type and State issued.

  9. if yes please indicate type of offense and dates

  10. If yes give complete details:(Date, Place, Charges, Disposition

  11. NOTE: A conviction will not necessarily bar you from employment. Each conviction will be judged on its own merits with respect to time, circumstances and seriousness.

  12. "We are An Equal Opportunity Employer"

  13. Education

  14. Yes or No

  15. please select GED/USAFI

  16. Yes or No

  17. If the Position you are applying for requires a college degree, or you wish to volunteer any secondary educational information, please complete the following:

  18. yes or No

  19. References

  20. Give name, address, and telephone number of three(3) references who are not related to you and are not previous employers.

  21. Work History

  22. Describe your work history beginning with your current or most recent job.Include military and volunteer experience. Failure to give complete information regarding each job held may result in your disqualification. Complete addresses with zip codes and telephone numbers for all employers are necessary. A resume may be attached only as additional information and will not be accepted in lieu of completing this section.

  23. Yes or No and if Yes, Why

  24. from - To

  25. From- To

  26. From- To

  27. Drug Test Consent and Information Release Form

  28. I understand that one of the components of the Oconee County Drug and Alcohol Policy is a urine test for drugs and/or alcohol as a condition of employment. A positive test will result in:

    a) Denial of Employment; b) Disciplinary Action to include termination of employment.

  29. I authorize the testing laboratory to release the results of this drug and alcohol test only to the Oconee County Medical Review Officer or designee, the Oconee County Board of Commissioners and their legal counsel, the applicable Department Head,those Oconee County employees who have a valid need to know,or those involved in any appeal process should it become necessary. I understand that this information will otherwise be kept confidential and will not be released without mu written consent or as is otherwise permitted by law. I release the medical personnel and any and all of their employee/owners or representatives from any and all liabilities arising from the release or use of the information derived from or contained in my drug results.

  30. During the process of testing a urine specimen for drugs, the specimen is also tested for excessive dilution (excess water in the specimen). In order for the specimen to be a valid specimen, it must not be a dilute specimen. For 6 hours before the test, please do not drink more that 12 ounces of liquid including alcohol or caffeinated beverages(such as sodas, coffee, or tea) or take a diuretic(water pill) unless medically necessary. If you take diuretics prescribed by a physician, and it is medically necessary that you take the diuretic on the day of the specimen collection, please inform the collector at the time that the specimen is collected. The prescription for the diuretic will need to be verified by the medical review officer if the specimen is dilute.

  31. Read, acknowledged and consented to, this

  32. 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.

  33. Applicant's Certification and Agreement Authorization to Release Information Conditions of Employment

  34. I hereby certify that the information provided by me in this application is true and complete, and I understand that misrepresentations, omissions of facts, or falsifications on this application are grounds for refusal to hire, or if employed, may be considered as constituting grounds for disciplinary measures or termination.

  35. I authorize any person(s), firm or organization listed herein to furnish Oconee County with any and all information concerning my previous employment, education, or any other information, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from an liability for any damage which may result from furnishing such information to Oconee County.

  36. I authorize you to request, receive, and verify all information given in this application.

  37. If I am employed by Oconee County, I agree to conform to the policies, rules and regulations of the employer set forth in the Personnel Policies of Oconee County and acknowledge that these policies, rules and regulations may be changed, interpreted, withdrawn, or added to by the employer at any time, at the employer's sole option.

  38. I further acknowledge that if I am employed by Oconee County, my employment will be at-will and may be terminated with or without cause at any time by me or by Oconee County until I become a non-probationary employee.

  39. I also understand that I will only be considered for the position(s) I have specified on this application and that ninety (90) days from the date of this application, all consideration for employment may cease unless I notify Oconee County Personnel that I am still interested in employment

  40. Yes, No or Not Applicable

  41. You must sign the Certification and Agreement, Authorization to Release Information and Conditions of Employment form to enable us to contact prior employers, even though we may not contact your present employer

  42. 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.

  43. Pursuant to Title II ADA and Section 504 of the Rehabilitation Act of 1973, as amended, no otherwise qualified individual with a disability in the United States shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance or under any program or activity conducted by Oconee County, Georgia. Additionally, pursuant to Title VI of the Civil Rights Act of 1964 and the Civil Rights Restoration Act of 1987, no person shall on the grounds of race, color, or national origin be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity conducted by Oconee County, Georgia.

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