City of St. Charles
Human Resources Department
2 East Main Street 
St. Charles, IL 60174    
 


 
 
 



Application for Employment

It is the policy of the City of St. Charles to provide all persons equal employment opportunities. This policy prohibits discrimination because of race, religion, national origin, ancestry, age, sex, sexual orientation, marital status, or physical or mental impairments unrelated to ability to perform essential job functions. We welcome you as an applicant for employment.

All information contained in or connected with this application will be considered personal and confidential and used only in conjunction with your possible employment by the City of St. Charles. Please furnish us with COMPLETE information as outlined in this application. Incomplete applications will NOT be considered. You are encouraged to submit a resume or any other additional information, which you believe relates to your qualifications for the position for which you are applying.

An * represents a required field. 

Please select the position you would like to apply for. By selecting 'Any Available Opening' you will not be considered for specific open positions listed, but applications will be reviewed for future openings and kept on file for up to 3 months.

* Position(s) Applied For:  

                                            

                                             

Date of Application:  



Personal Information

*Last Name 
*First Name 
Middle Name
*Street Address 
*City 
 
*State 
*Zip-code
Home Phone
Cell Phone
Email Address

Date available for work:

   


   

Work Type

Please indicate the type of employment desired.

 


Referral Source

Please indicate how you heard about the job you are applying for.






 
Please list the name of the referral source you chose or describe the source if you chose "Other Source".   


Background Information

Have you filed an application here before?
If yes, give position applied for:
Have you ever been employed here before?  
If yes, give dates. From: To:  
Is any of your employment data under a different name?
If yes, state name: Last Name: First Name: Middle Initial:
                                         
If hired, can you provide proof that you are authorized to work in the United States on an unrestrictive basis?
(Proof of U.S. citizenship or immigration status will be required upon employment.)
Are you capable of satisfactorily performing the essential job duties of the position, with or without reasonable accommodation, for which you are applying? (see position description)
Have you ever pled guilty or "no contest" to, or been convicted of a serious misdemeanor or felony?  Such conviction may be relevant if job related, but does not bar you from employment.  (Convictions for marijuana related offenses that are more than two years old need not be listed.)  
If Yes, please give dates and details:
 
Do you have a valid driver's license?
Do you have a valid Commercial Driver's License (CDL)?


Education

Please indicate the last three that you have attended.

School/Technical Training 

Years Completed

Degree or
Diploma

GPA/Class Rank

Major

Minor



References

List name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.

Name

Telephone Number

Years Known

Type



 



 



 



Employment History

List your last four (4) employers, assignments or volunteer activities, starting with the most recent, including military experience. Explain any gaps in employment in comments section below.


Employer #1

Employer:

Phone:

 

Address:

Dates Employed

From:
 

To:

Summarize the nature of the work performed and job responsibilities.

 
 

Job Title:

Hourly Rate/Salary

Starting

$ per

Final

$ per

Immediate Supervisor:

Reason for Leaving:

 

May we contact for Reference?


Employer #2

Employer:

Phone:


Address:

Dates Employed

From:

To:

Summarize the nature of the work performed and job responsibilities.

 

Job Title:

Hourly Rate/Salary

Starting

$ per

Final

$ per

Immediate Supervisor:

Reason for Leaving:

 

May we contact for Reference? 


Employer #3

Employer:

Phone:


Address:

Dates Employed

From:

To:

Summarize the nature of the work performed and job responsibilities.

 

Job Title:

Hourly Rate/Salary

Starting

$ per

Final

$ per

Immediate Supervisor:

Reason for Leaving:

 

May we contact for Reference? 


Employer #4

Employer:

Phone:


Address:

Dates Employed

From:

To:

Summarize the nature of the work performed and job responsibilities.

 

Job Title:

Hourly Rate/Salary

Starting

$ per

Final

$ per

Immediate Supervisor:

Reason for Leaving:

 

May we contact for Reference?



Comments:

Including an explanation of any gaps in employment.

 


Skills and Qualifications:

Summarize special skills, qualifications, or training acquired from employment or other experiences that may qualify you to work for the City.

  


Professional Certifications:

Please list any professional certifications you have in this area. 

 


Resume:

If you would like to send your resume with this application please upload it here. Your resume will not appear on the review page.

*Are you including a resume?   
Resume must have a .doc, .docx, .txt or .pdf extension.
Upload Your Resume: 
 

                       


Please Read Carefully

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that falsified statements or omission of facts on this application shall be considered sufficient cause for termination of employment or cancellation of application.

I understand and agree that the City of St. Charles is hereby authorized thouroughly investigate my character, employment record, references, education, and other matters related to my suitability for employment. I further understand that such inquiries will include checking police records for convictions. I hereby release from liability the employer and its representative for seeking such information and all other persons, corporations or organizations for furnishing such information. I understand that I may request reasonable accommodation if needed, due to disability, in order to participate in the overall application process.

This application is current for 3 months from the date it was submitted. At the conclusion of this time, if I have not heard from the City and still wish to be considered for employment, it will be necessary to complete a new application.

I understand the filing of this application or participation in an interview in no way constitutes an employment contract between the City of St. Charles and me. I acknowledge the right of the City of St. Charles to make changes in policy and benefits where not specified or covered by contract without notice.

I understand that any offer of employment is conditional upon the successful completion of a background check, drug screen and/or physical exam. Should I become employed, I agree to conform to all rules and regulations of the City of St. Charles. I understand that I have the right to terminate my employment at any time and the City of St. Charles retains the same right.



Signature

   
Your application will not be accepted unless this box is checked.

*Signature of Applicant:  

Date:  


Make sure your application is filled in as completely as possible before clicking submit. 
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