Employment Application - City of Norton Shores

Personal Information

Name *

Phone Number *

Email Address *

Are you 18 years or older? * Yes
No

Are you a citizen of the United States? * Yes
No

If No, What Type of Visa?

Have you been convicted of a felony in the last 5 years? * Yes
No

If Yes, Provide Additional Information

Position Information

Title of position for which you are applying *

Available Start Date *

Days of Availability (if applicable)?

Available for Overtime (if applicable)?

Education and Experience

High School Name

Address

Did you graduate? Yes
No

Degree/Diploma Earned and Graduation Date

College or University Attended

Address

Did you graduate? Yes
No

Degree/Diploma Earned and Graduation Date

Additional Degree, License, Registration and/or Certificate (include issuing authority, date issued and expiration date, if applicable)

Military Experience

Branch and Rank

Duties

Total Years in Service

Skills and Qualifications

Do you speak a language other than English? Yes
No

If yes, which language(s) and with what proficiency?

Employment History

Are you currently employed? * Yes
No

Name of Most Recent Employer

Address

Phone Number

Position Held *

Duties

Dates of Employment

Ending Pay Rate *

Reason for Leaving

Supervisor's Name

May we contact your previous supervisor for a reference? Yes
No

Name of Previous Employer

Address

Phone Number

Position Held *

Duties

Dates of Employment

Ending Pay Rate *

Reason for Leaving

Supervisor's Name

May we contact your previous supervisor for a reference? Yes
No

References

Name and Address of Reference #1 *

Occupation and Company of Reference #1 *

Phone Number *

Reference Type * Personal
Professional

Name and Address of Reference #2 *

Occupation and Company of Reference #2 *

Phone Number *

Reference Type * Personal
Professional

Name and Address of Reference #3 *

Occupation and Company of Reference #3 *

Phone Number *

Reference Type * Personal
Professional

Do you have any relatives currently employed by the City of Norton Shores (including City Council members)? * Yes
No

If yes, please list the name and relationship.

Do you have a CDL? * Yes
No

Resume or CV

In addition to filling out this application in full, please email your resume or CV to apply@nortonshores.org. Please put the Position Title in the subject of your email.

Agreement: I certify that the information provided in this application is true and complete. I acknowledge that false information is grounds for not hiring me or immediate termination. I authorize the verification of any information listed above.

Signature (Please Type Your Name) *

Date