Employment Application – Euclid Police – 545 E 222nd St

Equal Employment Policy

It is the policy of the City of Euclid to seek and employ the best qualified individuals for all positions, to provide equal opportunity for the advancement of employees, including upgrading, promotion and training: and to administer these activities in a manner which will not discriminate against any person because at race, religion, sex, age, disability, color or national origin.

Personal Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Work Phone*

Email*

Do you have a work permit if you are under 18 years of age?

Yes
No

Do you have a valid Ohio driver’s license?*

Yes
No

Drivers license number

Position(s) Applied For

Include Department - Number - Position Title

1

2

3

Education - College

College name & location

College last year completed

College graduate?

Yes
No

Type of degree or diploma

Major area of study

Education - High School

High School name & location

High School last year completed

9
10
11
12

High School graduate?

Yes
No

Type of degree or diploma

Major area of study

Education - U.S. Military

Name & location

Major area of study

Conviction Information

Conviction Information will not necessarily bar an applicant from employment.

Have you ever been convicted of a crime other that a minor traffic violation?*

Yes
No

If yes, give date, reason, disposition of case, and place of violation

Employment History

Starting with your present or most recent employer, list your work experience for at least the last ten years. Please account for all periods of unemployment in this section. Use the last page of the application form if you need additional space. DO NOT USE "Refer to resume".

Present Employer

Address

Street Address Address Line 2 City State ZIP Code

Phone

Date Started

MM

DD

YYYY

Starting Pay

Date Ended

MM

DD

YYYY

Ending Pay

Reason for Leaving

Duties Performed

Name & Title of immediate supervisor

Do you need to add a second employer?

Yes
No

Employer

Address

Street Address Address Line 2 City State ZIP Code

Phone

Date Started

MM

DD

YYYY

Starting Pay

Date Ended

MM

DD

YYYY

Ending Pay

Reason for Leaving

Duties Performed

Name & Title of immediate supervisor

Do you need to add a third employer?

Yes
No

Employer

Address

Street Address Address Line 2 City State ZIP Code

Phone

Date Started

MM

DD

YYYY

Starting Pay

Date Ended

MM

DD

YYYY

Ending Pay

Reason for Leaving

Duties Performed

Name & Title of immediate supervisor

References

Give name, address and telephone number of three references who are not related to you

Applicant’s Statement

I certify that the information contained in This application is true and complete to the best of my knowledge. I understand that, if employed, false statements or omissions on this application are grounds for immediate disqualification or dismissal upon discovery thereof. I authorize all, persons, schools, companies, and government agencies to give you any and all information concerning my background, any pertinent information they may have, personal or otherwise and release all parties from liabilities for any damage that may result from furnishing the same to you. I understand that I may be required to undergo medical examinations before beginning work to determine my ability to perform the duties of the position applied for and failure to undergo such medical examinations shall be grounds for disqualification. In consideration of my employment, I agree to abide by the City’s ordinances, rules and regulations. I understand that my employment and compensation can be terminated with or without cause and with or without prior notice, at any time, at the option of either the City or myself. I understand that no manager or supervisor other than The Mayor has any authority to employ persons on behalf of the City, but not contrary to the foregoing. I hereby authorize the City of Euclid to release this application to private or public employers seeking to fill job openings.

Date*

Additional Information

List skills, interests. Languages spoken or read, licenses, certifications, etc.

City of Euclid EQUAL EMPLOYMENT OPPORTUNITY

Responses to these questions are OPTIONAL. These questions are included to assist our equal employment opportunity efforts. Providing this information is VOLUNTARY and will in no way affect the processing of your application or your being considered for employment. We will process your responses to these confidential questions separately. Responses will be used for statistical purposes only.

Position Applied For

Date

OPTIONAL! Please indicate your sex

Male
Female

OPTIONAL! Please indicate your age group

OPTIONAL! Please indicate your race/ethnicity:

WHITE: All persons having origins in any of the original peoples of Europe, North Africa or the Middle East.
BLACK or AFRICAN AMERICAN: All persons having origins in any of the Black racial groups of Africa.
HISPANIC or LATINO: All persons of Mexican, Puerto Rican, Cuban, Central or South America, or other Spanish culture or origin, regardless of race.
ASIAN: All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent (for example, China, India, Japan and Korea).
NATIVE HAWAIIAN or PACIFIC ISLANDER: All persons having origins in any of the original peoples of the Hawaiian Islands and Pacific Islands (for example, Hawaii, Philippine Islands and Samoa).
AMERICAN INDIAN or ALASKAN NATIVE: All persons having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition.

OPTIONAL! Are you an individual with a physical or mental impairment which substantially limits one or more of your major life activities?

Yes
No

OPTIONAL! Are you a veteran?

Yes
No

OPTIONAL! If you answered Yes to the previous question, please indicate if one or more of the following apply

MILITARY STATUS: The performance of duty in a uniformed service, to include active duty, active duty for training, initial active duty for training, inactive duty for training, full-time National Guard duty.
DISABLED VETERAN: A person whose discharge or release from active duty was for a disability incurred or aggravated in the line of duty.
DESERT STORM/SHIELD VETERAN: A person whose active duty was performed after August 2, 1990, in the Persian Gulf Conflict.
VIETNAM ERA VETERAN: A person served on active duty for a period of more than 180 days, any part of which occurred between August 5, 1964, and May 7, 1975.