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Step Three

WORK HISTORY
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.
Have you ever been disciplined or fired?*
1. Yes
1. No
If yes, why?
Company Name:*
Phone Number:*
Address (street name, city, state, and zip):*
Employment Dates:
Employment Dates: Start Date
—
Employment Dates: End Date
Position held:*
Annual Salary:*
Name of Supervisor:*
Reason for Leaving:*
Describe your duties:
Company Name:
Phone Number:
Address (street name, city, state, and zip):
Employment Dates:
Employment Dates: Start Date
—
Employment Dates: End Date
Position held:
Annual Salary:
Name of Supervisor:
Reason for Leaving:
Describe your duties:
Company Name:
Phone Number:
Address (street name, city, state, and zip):
Employment Dates:
Employment Dates: Start Date
—
Employment Dates: End Date
Position held:
Annual Salary:
Name of Supervisor:
Reason for Leaving:
Describe your duties:
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Step Four

Attach Resume and/or Cover Letter:
Drug Test Consent and Information Release Form
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.
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 my 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.
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 than 12 ounces of liquid including alcohol or caffeinated beverages (such as sodas, coffee, or tea) or take a diuretic (water pill) unless it is medically necessary. If you take diuretics prescribed by a physician, and it is medically necessary that you take the diuretic on the day of 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.
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.
1. I agree.
Applicant's Electronic Signature*
Signature Date:*
Signature Date:
Applicant's Certification and Agreement Authorization to Release Information Conditions of Employment
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.
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 all liability for any damage which may result from furnishing such information to Oconee County.
I authorize you to request, receive, and verify all information given in this application. 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.
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. 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 Human Resources that I am still interested in employment.
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
May we contact your present employer?*
1. Yes
1. No
1. N/A
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.
1. I agree.
Applicant's Electronic Signature*
Signature Date:*
Signature Date:
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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Oconee County Job Application

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