Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Position You Are Applying For {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Department {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Personal Information

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Birthday {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Last 4 Digits of SSN {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Current Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

How long have you lived here? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Previous Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Are you a current City of Sumter employee or have you worked for the City of Sumter in the past? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If so, when? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

What Department? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please list any relatives employed by the City of Sumter

Relative {binding ItemNumber}

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Department {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Do you have a valid Driver's License? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

License Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

State {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Expiration Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Restrictions {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Do you have a valid CDL Driver's License? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

License Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

State {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Expiration Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Restrictions {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Have you ever been convicted or entered a plea of no contest, or a plea of guilty to a crime(s) other than misdemeanors and summary offenses which have not been annulled, expunged or sealed by court? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If yes, please explain and provide dates: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

NOTE: Conviction does not necessarily bar you from consideration for employment.

Have you ever been fired or asked to resign from a job? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If yes, please give date, name and address of employer, and reason. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

A firing or forced resignation does not automatically mean that you cannot be employed. The circumstances, time elapsed, and recent employment record will be considered. However, failure to be completely honest and accurate about such circumstances may cause your application to be disqualified for consideration.

Education History

High School Attended {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Location {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Highest Grade Completed {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Do you have a high school diploma or an equivalency diploma (GED)? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If so, from where? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

College or University

School {binding ItemNumber}

Name of College {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Type of School {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Degree / Certificate Completed {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Number of Years Completed {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Major / Minor Field(s) of Study {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

May We Contact Your Present Employer? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If no, please explain. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Proficient in: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Words Per Minute Typing: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employment History

Employer {binding ItemNumber}

Name of Employer {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Start Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

End Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

How Many Hours Per Week? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Job Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Number of People Supervised {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Name & Title of Immediate Supervisor {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Supervisor's Phone Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Description of Duties {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Machines and Equipment Used {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Reason for Leaving {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Your Name When Employed (If Different) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

May we contact your current employer? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If no, please explain. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

References

Reference {binding ItemNumber}

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Use this space to include any special qualifications and skills or additional information that you feel will help us better evaluate your application. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

I hereby affirm that all statements made herein are true and correct. I authorize investigation into all statements and references contained in this application. Said investigation may include credit, driving, criminal background, references and other background checks. By applying for this job, I also authorize post-hire investigation into my credit, driving, and criminal background. If investigation determines any untrue statements, I accept this as sufficient grounds for refusal to hire or dismissal. I also authorize current and former employers to release information regarding my employment. I agree to submit myself for a pre-employment physical examination and drug test by a physician selected by the City, and I understand that failure to meet the physical requirements or refusal to be examined may disqualify me from employment.

Applicant's Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Resume {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Cover Letter {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}