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Applicant's Statement
I certify that answers given herein are true an complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing ot be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will' nature, which means that the Employee amy resign at ant time and the Employer amy discharge Employee at any time with or without cause. I t is further understood that this "at will' employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interviews(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
 

Signature of Applicant: _________________________________________________________   Date: 
 

FOR PERSONNEL DEPARTMENT USE ONLY
Arrange Interview 

Remarks__________________________________________________________________

Interview Date_______________________

Employed

Date of Employment______________________

Job Title____________________  Hourly Rate/Salary______________

Department__________________________________

By (Name and Title)__________________________________  Date___________________

Yes_____  No_____
 
 
 
 

Yes_____  No_____
 
 
 
 
 
 

 

 

Please Fill Out & Print Each Page of Application and Mail to:
Sherri Cromer, Personnel Clerk
City of West Plains
P. O. Box 710
West Plains, MO 65775-0710

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