The City of Rocky Mount, NC, extends an opportunity to potential employees through its Application for Employment, emphasizing its stance as an Equal Opportunity Employer. This comprehensive form seeks to gather various details to evaluate applicants fairly and place them in positions that align with their qualifications and experience. Applicants are requested to provide information ranging from personal details, employment preferences, educational background, and work history to specifics like military service and clerical skills. Noteworthy is the city's commitment to accommodating applicants with disabilities, ensuring they receive the necessary assistance during the application process. Moreover, the form includes a declaration by the applicant to certify the accuracy of the information provided, underlining the importance of honesty in the application process. The application not only adheres to the City of Rocky Mount's non-discrimination policy regarding race, sex, national origin, disability, age, creed, color, or religion but also highlights the city's drug and alcohol policy, requiring all potential employees to pass a medical examination that includes a drug screening test. Through this detailed application process, the City of Rocky Mount aims to attract and evaluate candidates in a manner that is both thorough and fair, contributing to the community's well-being by hiring competent and reliable public servants.
| Question | Answer |
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| Form Name | Rocky Mount App Form |
| Form Length | 5 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 15 sec |
| Other names | dmv application online for a job for new rocky mount office, ebc rocky mt app, anization, n-exempt |
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APPLICATION FOR EMPLOYMENT |
AN EQUAL |
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City of Rocky Mount, NC |
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OPPORTUNITY EMPLOYER |
To Applicants: We appreciate your interest in our organization and assure you that we will carefully consider your qualifications. Please complete the application form thoroughly and accurately. A clear understanding of your background and work history will aid us in placing you in the position that best meets your qualifications.
*If you have a disability, and you need special assistance in order to complete the application process (including written examinations, oral interviews, filling out application forms, etc.) please see the receptionist.
PERSONAL
1.Position applied for ________________________________________________ Date of Application _____________
2.Name _______________________________________________________
(LastFirstMiddle)
3. Mailing Address _________________________________________________________________________________
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Street & No. or RFD |
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City |
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4. |
Do you reside in the Rocky Mount City Limits |
YES |
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NO |
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5. |
Telephone: |
Home ______________ |
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If none, where can you be reached by phone?__________________________ |
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Business ______________ |
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Resident’s Name ____________________________________________ |
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6. |
Are you: |
Under 18 |
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Over 18 |
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7. |
Do you want to work |
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or |
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Specify days and hours if |
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Are you willing and able to work rotating shifts? |
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8.How did you learn of this opening? __________________________________________________________________
9.Have you worked for the City before? __________ If yes, when and what position did you hold? ________________
________________________________________________________________________________________________
10.List any relatives working for the City ________________________________________________________
_________________________________________________________________________________________________
11.If hired, on what date will you be ready to start work? ___________________________________________________
12. Have you ever been convicted of a crime, including misdemeanors and summary offenses? No |
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Yes |
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Please list offense(s) and date(s) of conviction(s) _________________________________________________________
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Note: You may omit any other offense committed before your 16th birthday which was finally heard in a juvenile court or under a youth offender law.
13.Do you have a valid driver’s license? _________ Driver’s License Number & Type/State _______________________
List all traffic convictions, location & date of all traffic convictions _____________________________________________
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14.Clerical Skills: Typing __________________ Shorthand:______ ______________ Other: ____________________
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15.Are there any other experiences, skills, or qualifications which you feel would be important to include?
_________________________________________________________________________________________________
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MILITARY HISTORY
Have you ever served in the armed forces? YES |
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NO |
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If yes, what branch? _____________________ |
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Dates of duty: From ______________ To ______________ |
Any current reserves or military obligation? __________ |
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FOR MALES AGE 18 THROUGH 25 ONLY
Males who are 18 through 25 are required to register with the Federal Government in accordance with the Military Selective Service Act. State law prohibits local government from employing anyone who has not complied with this requirement.
Please indicate if you have registered for Selective Service: ______YES ______NO
EDUCATIONAL BACKGROUND
TYPE OF SCHOOL
Grammar or Grade
High School
College
Post Graduate
Business or Trade
Technical
Other
NAME & ADDRESS
HOW MANY YEARS
ATTENDED?
DATE
GRADUATED
COURSE OR MAJOR
If you did not graduate from High School, did you obtain your GED equivalency? |
YES |
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NO
WORK HISTORY
List the jobs that you have held, beginning with your last or present employer. Include
A.
B.
Dates
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Number Hrs./
Week
Job Title
Dates
From |
To |
Number Hrs./
Week
Job Title
Name & Address of Employer |
Rate of Pay |
Supervisor’s Name |
Reason for |
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Start |
Finish |
& Phone Number |
Leaving |
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Describe briefly the work you did:
Name & Address of Employer |
Rate of Pay |
Supervisor’s Name |
Reason for |
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Start |
Finish |
& Phone Number |
Leaving |
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Describe briefly the work you did:
C.
D.
Dates
From |
To |
Number Hrs./
Week
Job Title
Dates
From |
To |
Number Hrs./
Week
Job Title
Name & Address of Employer |
Rate of Pay |
Supervisor’s Name |
Reason for |
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Start |
Finish |
& Phone Number |
Leaving |
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Describe briefly the work you did:
Name & Address of Employer |
Rate of Pay |
Supervisor’s Name |
Reason for |
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Start |
Finish |
& Phone Number |
Leaving |
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Describe briefly the work you did:
May we contact the employers listed above? _________ If not, indicate below which ones you do not wish us to contact.
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PERSONAL REFERENCES
List three (3) persons who are not related to you who have definite knowledge of your qualifications and fitness for the position for which you are applying. Do not repeat names of supervisors in WORK HISTORY.
Name & Occupation
Address
Phone Number
DECLARATION OF APPLICANT:
I hereby certify that there are no willful misrepresentations, omissions, or falsifications in the foregoing statements and answers to questions. I am aware that should an investigation disclose any misrepresentation, omission, or falsification, my application may be rejected, or if already employed, my employment may be terminated.
______________________________________________ |
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APPLICANT’S SIGNATURE |
DATE |
NOTICE TO APPLICANTS
It is the policy of the City of Rocky Mount not to discriminate on the basis of race, sex, national origin, disability, age, creed, color, or religion in any employment decision.
RETURN APPLICATION TO:
Human Resources Department
City of Rocky Mount
P.O. Drawer 1180
Rocky Mount, NC
Telephone: (252)
Fax: (252)
Email: jobs@rockymountnc.gov
http://www.rockymountnc.gov
NOTICE TO APPLICANTS
It is the policy of the City of Rocky Mount to ensure that its employees are free from the effects of alcohol and drugs. All applicants selected for emplyment must satisfactorily pass a medical examination which includes a drug screening test. T hose applicants with a confirmed positive test for drugs/alcohol will not be hired.
Mission
The mission of the City of Rocky Mount is to provide courteous and responsive public service of the highest quality and value for the benefit and enjoyment of our community and its citizens.
In accordance with the Americans with Disabilities Act, the City of Rocky Mount
will consider reasonable accomodations if requested.
ONE GOVERNMENT PLAZA |
ROCKY MOUNT |
POST OFFICE BOX 1180 |
NORTH CAROLINA |
Please a nswer the fo llowing questions to he lp us comply with Federal/State equal employment opportunity recordkeeping, reporting, and other legal requirements.
This information w ill n ot be us ed in co nsidering you fo r em ployment and the P
1. N ame:________________________________________________________________________
2. |
Birthdate:_________/________/_________ |
3. S.S.#______________________________ |
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4. |
Race/Ethnic Group: |
__________White |
___________African American |
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__________Hispanic |
___________American Indian |
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__________Other ______________________________________________ |
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5. |
Sex: __________Male |
___________Female |
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6. |
Marital Status: |
__________Single |
___________Married |
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__________Divorced |
___________Widowed |
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NOTICE TO APPLICANTS
OVERTIME POLICY AND AGREEMENT FOR NON_EXEMPT POSITIONS
Consistent with the provisions contained in the 1985 amendments to the FAIR LABOR STANDARDS ACT, i t is the City’s policy to com pensate
If I am e mployed i n a no
Applicant Signature:______________________________________ Date:________________
DRUGS/ALCOHOL POLICY
It is the policy of the C ity of Rocky M ount to ensure that its employees are free from the effects of alcohol and drugs. All applicants se lected f or em ployment must sati sfactorily pass a m edical examination which includes a drug screening test. Those applicants with a confirmed positive test for drugs/alcohol will not be hired.