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Employment Application

INSTRUCTIONS: Answer all questions completely and honestly. Type or print all answers. Sign the application and any supplemental forms. An applicant will not be considered without a completed application. Resumes are accepted, but only in addition to the application. Any omission, mis-statement, or falsification may be cause for you to be removed from further consideration in the employment process or discharged from District service. Applications must be received by the posted deadline, whether submitted in person, by fax, or by e-mail. The Rock Island County Forest Preserve District is not responsible for applications that are not received by the posted deadline.

General Information

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Have you ever used or been known by any other names?:
Have ever been employed by Rock Island County Forest Preserve District?:
Have you ever been terminated, discharged, or asked to resign from any employment? :
In the last seven years have you ever been convicted of a violation of law other than a minor traffic violation?:
(Applicant not obligated to disclose expunged juvenile records of adjudication or arrest.) (The term “convicted” includes any conviction, a guilty plea, a no contest plea, a suspended sentence, or a deferred judgment.  Conviction of a crime does not necessarily constitute automatic bar from employment.) 
I will accept (check all that apply) Regular :
I will accept (check all that apply) Temporary :
I will accept (check all that apply) Shifts:
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Do you have a legal right to work in the U.S.?:
All new hires will be required to submit verification of the legal right to work in the United States within (3) business days of employment. In accordance with the Immigration Reform and Control Act of 1986 we are legally prohibited from employing anyone who cannot provide such verification.
Are you 18 years of age or older? :

Education, Training, and Skills

Proof of education and/or professional certifications may be required prior to hire.

Driver’s License Information:

Do you have a valid driver’s license?:
CDL?:
Do you have a high school diploma or G.E.D.?:

Education Information:

Degree Completed:
Degree Completed:
Degree Completed:

Professional Registrations, Licenses, and/or Certifications that relate to this position:

(if applicable)
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(if applicable)

Employment History

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May we contact this employer? :
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May we contact this employer? :
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May we contact this employer? :

Professional References - Provide at Least Three

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