Application for Employment - The Official Website of Brewton, Alabama

Name*

Street Address

Apartment / Unit #

City*

State*

ZIP*

Phone*

Email*

Date Available

Desired Salary

Position Applied For

Are You A Citizen of the United States?

Yes

No

If no, are you authorized to work in the US?

Yes

No

Have you ever worked for the City of Brewton?

Yes

No

If yes, when?

Have you ever been convicted of a felony?

Yes

No

If yes, explain

Education

High School

Address

From

To

Did You Graduate?

Yes

No

Degree

College

Address

From

To

Did You Graduate?

Yes

No

Degree

Other

Address

From

To

Did You Graduate?

Yes

No

Degree

Please list any specialized training, apprenticeships, skills, certifications, and/or extracurricular activities:

Previous Employment

Company

Address

Phone

Job Title

Supervisor

Starting Salary

Ending Salary

From

To

Responsibilities

Reason for leaving

May we contact this supervisor for a reference?

Yes

No

Company

Address

Phone

Job Title

Supervisor

Starting Salary

Ending Salary

From

To

Responsibilities

Reason for leaving

May we contact this supervisor for a reference?

Yes

No

Military Service

Branch

From

To

Rank at discharge

Type of discharge

If other than honorable discharge, please explain

References

Please list three professional references. (name, relationship, company and contact info)

Reference 1

Reference 2

Reference 3

Certify

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

You may be asked to sign this application and provide additional information during a potential interview.

Current Job Openings

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Education

Previous Employment

Military Service

References

Certify

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