EMA - Job Application

2. Job Application
   St. Clair County considers all applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. In addition, St. Clair County complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities. St. Clair County also provides reasonable accommodation to individuals with a disability in accordance with applicable laws.

   St. Clair County considers all applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. In addition, St. Clair County complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities. St. Clair County also provides reasonable accommodation to individuals with a disability in accordance with applicable laws.

4. Job Description Details
   Please enter the "Job Code", "Location", and "Job Keyword" in the below section. This information can be found on the online job posting. If the job posting does not have the information, please enter "N/A".

   Please enter the "Job Code", "Location", and "Job Keyword" in the below section. This information can be found on the online job posting. If the job posting does not have the information, please enter "N/A".

6. Job Code*

7. Location*

8. Job Keywords*

10. Fields marked with a red star are Required Fields. The application form will not automatically save your work as you go. You may wish to type out your answers in a text editor such as Word or Notepad first and then copy and paste your answers into our online application as you complete each item.

    Fields marked with a red star are Required Fields. The application form will not automatically save your work as you go. You may wish to type out your answers in a text editor such as Word or Notepad first and then copy and paste your answers into our online application as you complete each item.

12. Salutation
    -- Select One --Mr.MissMrs.Ms.Dr.Rev.

14. First Name*

15. Middle Name

16. Last Name*

18. Suffix
    -- Select One ----Jr.Sr.IIIIVMDDVM

20. Address*

22. City*

23. State*

24. Zip Code*

26. Phone Number*

27. Email Address*

31. Type of Employment Desired

    1. Full Time

    1. Part Time

    1. Temporary

33. Days Available

    1. Monday
    2. Tuesday

    1. Wednesday
    2. Thursday

    1. Friday
    2. Saturday

    1. Sunday

35. Hours Available

37. Willing to Work Overtime

    1. Yes

    1. No

39. Geographical Preference (Ashville/Pell City/Either *

    1. Ashville

    1. Pell City

    1. Either

41. Date You Can Start

45. Have You Ever Been Employed by Us*

    1. Yes

    1. No

47. If Yes, When?

48. What Position?

52. Is there anything that would prevent you from performing in a reasonable and safe manner the activities involved in the position for which you have applied?

    1. Yes

    1. No

54. If Yes, Please Explain

58. Have you ever been convicted of a crime?*

    1. Yes

    1. No

60. If yes, state nature of offense, when, where, and disposition.

    *A conviction record will not necessarily be a bar to employment. This information will be used only for job-related purposes and only to the extent permitted by applicable law.

64. Federal laws require that employers hire only individuals who are authorized to be lawfully employed in the United States. In compliance with such laws, St. Clair County will verify the status of every individual offered employment with the County. In this connection, all offers of employment are subject to verification of the applicant's indentity and employment authorization, and it will be necessary for you to submit such documents as are required by law to verify your identity and employment authorization.

68. COMPLETE THIS SECTION ONLY IF YOU ARE APPLYING FOR POSITIONS INVOLVING DRIVING

70. Are you a licensed driver?

    1. Yes

    1. No

72. Do you have a car available for work?

    1. Yes

    1. No

74. Do you have a Commercial Driver's License (CDL)?

    1. Yes

    1. No

76. If yes, what type of CDL do you have?

80. Do you have the legal right to work and remain in the United States?

    1. Yes

    1. No

82. State name of any relative in our employ

86. Record of Education

88. School #1 - Name and Address of School

90. School #1 - Course of Study

91. School #1 - Number of Years Completed

93. School #1 - Did You Graduate?

    1. Yes

    1. No

95. School #1 - Diploma or Degree Received

99. School #2 - Name and Address of School

101. School #2 - Course of Study

102. School #2 - Number of Years Completed

104. School #2 - Did You Graduate?

     1. Yes

     1. No

106. School #2 - Diploma or Degree Received

110. School #3 - Name and Address of School

112. School #3 - Course of Study

113. School #3 - Number of Years Completed

115. School #3 - Did You Graduate?

     1. Yes

     1. No

117. School #3 - Diploma or Degree Received

121. School#4 - Name and Address of School

123. School #4 - Course of Study

124. School #4 - Number of Years Completed

126. School #4 - Did you Graduate?

     1. Yes

     1. No

128. School #4 - Diploma or Degree Received

132. Do you have any MILITARY QUALIFICATIONS which would apply to this job? List duties, including special training, that is relevant to this position.

136. SKILLS (that you believe are related to the job for which you are applying)

138. Shorthand (W.P.M.)

140. Typing (W.P.M.)

142. Skills with other office equipment

144. If you possess any Industry or State Certifications, Skills, or Abilities that especially qualify you for this position? Supply certification type & number(i.e. POST - Peace Officer Training Standards, ACM-Alabama Certified Mapper, NCIC , ACCA etc)

148. PRIOR WORK HISTORY (List in order with current or last employer fIrst.) Account for your entire employment history and for any gaps in your employment.

150. Work #1 - Dates (From and To)

152. Work #1 - Name, Address and Telephone Number

154. Work #1 - Rate of Pay (Start and Finish)

156. Work #1 - Supervisor's Name / Title

158. Work #1 - Reason for Leaving

160. Work #1 - May we contact this employer?

     1. Yes

     1. No

162. Work #1 - Describe in detail the work you performed

166. Work #2 - Dates (From and To)

168. Work #2 - Name, Address and Telephone Number

170. Work #2 - Rate of Pay (Start and Finish)

172. Work #2 - Supervisor's Name / Title

174. Work #2 - Reason for Leaving

176. Work #2 - May we contact this employer?

     1. Yes

     1. No

178. Work #2 - Describe in detail the work you performed

182. Work #3 - Dates (From and To)

184. Work #3 - Name, Address and Telephone Number

186. Work #3 - Rate of Pay (Start and Finish)

188. Work #3 - Supervisor's Name / Title

190. Work #3 - Reason for Leaving

192. Work #3 - May we contact this employer?

     1. Yes

     1. No

194. Work #3 - Describe in detail the work you performed

198. Work #4 - Dates (From and To)

200. Work #4 - Name, Address and Telephone Number

202. Work #4 - Rate of Pay (Start and Finish)

204. Work #4 - Supervisor's Name / Title

206. Work #4 - Reason for Leaving

208. Work #4 - May we contact this employer?

     1. Yes

     1. No

210. Work #4 - Describe in detail the work you performed

214. Work #5 - Dates (From and To)

216. Work #5 - Name, Address and Telephone Number

218. Work #5 - Rate of Pay (Start and Finish)

220. Work #5 - Supervisor's Name / Title

222. Work #5 - Reason for Leaving

224. Work #5 - May we contact this employer?

     1. Yes

     1. No

226. Work #5 - Describe in detail the work you performed

230. Additional Work Histories (please include same items as above, i.e., Dates, Names, Pay Rate, Supervisor, Reason for Leaving, Contact and Details of work performed.)

234. PERSONAL REFERENCES (Excluding relatives)

236. Personal Reference #1 - Name and Occupation*

238. Personal Reference #1 - Dates Known

240. Personal Reference #1 - Address (Street, City, State, Zip)

242. Personal Reference #1 - Telephone Number*

246. Personal Reference #2 - Name and Occupation*

248. Personal Reference #2 - Dates Known

250. Personal Reference #2 - Address (Street, City, State, Zip)

252. Personal Reference #2 - Telephone Number*

256. Personal Reference #3 - Name and Occupation*

258. Personal Reference #3 - Dates Known

260. Personal Reference #3 - Address (Street, City, State, Zip)

262. Personal Reference #3 - Telephone Number*

266. Additional Resume Information - Please add any additional information here that was not covered in the previous items.

270. Upload your Resume (Maximum file size of 5Mb and must be in PDF, DOC, DOCX, WPF format)

274. PREEMPLOYMENT STATEMENT
     (PLEASE READ VERY CAREFULLY BEFORE ELECTRONICALLY SIGNING BELOW) By typing my name in the Electronic Signature box below, I signify that I understand and voluntarily agree that:

     (PLEASE READ VERY CAREFULLY BEFORE ELECTRONICALLY SIGNING BELOW) By typing my name in the Electronic Signature box below, I signify that I understand and voluntarily agree that:

276. 1. The information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, can be justification for refusal of employment or termination.

278. 2. Any offer of employment I may receive from St. Clair County is contigent upon my successful completion of the County's total preemployment screening process, including the receiving of satisfactory references, and my satisfactory completion of any post-job offer/preemployement physical examination that the County may require.

280. 3. I understand that as a condition of employment, I may be required to undergo and successfully pass a screening for alcohol and/or drugs. I also understand and agree that, if employed, I may be required to submit to alcohol or drug screening at any time when my employer determines that a reasonable cause exists.

282. 4. In processing my application for employment, my employer may verify all the information provided by me, or may procure or have prepared a background report for this purpose concerning, among other things, my prior employment or military record, education, character, general reputation, personal characteristics, criminal record, and mode of living. I understand that upon written request to my employer, I will be informed of whether a background report was requested and given full information as to the nature and scope of this investigation.

284. 5. I authorize and request that all of my present and former employers and those individuals I have listed as personal references furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for employment, hereby releasing them from any and all liability for damages arising from furnishing the requested information.

286. 6. In consideration of my employment, I agree to comply with the policies, rules, regulations, and procedures of St. Clair County and understand that my employment with the County is voluntarily entered into, and that I am free to resign at any time, with or without cause. Similarly, the County may terminate the employment relationship, so long as there is no violation of applicable law. I further understand that no representative of St. Clair County has the authority to enter into an employment agreement with me except elected or appointed officials of St. Clair County who have the authority to hire, employ, and dismiss employees according to the provisions of local law.

288. 7. I understand, as a part of St. Clair County's DRUG-FREE WORKPLACE POLICY, I may be required to undergo Pre-employment Substance Testing at my own expense, (estimated to be approximately $40) at a location specified by St. Clair County.

290. Electronic Signature

Leave This Blank:


292. 1. Receive an email copy of this form.
293. Email address

     This field is not part of the form submission.

294. Submit

* indicates a required field