Swain County Employment Application

PERSONAL INFORMATION

Date:(Required)

SSN#:(Required)

Name:(Required)

First Last

Present Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Permanent Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone:(Required)

Email(Required)

Referred By:

First Last

EMPLOYMENT DESIRED

Position:(Required)

Date You Can Start:(Required)

Salary Desired:(Required)

Are You Employed?(Required)

Yes

If Yes, By Who?

If So, May We Inquire Of Your Present Employer?

Ever Applied Here Before?(Required)

Yes

If Yes, When?

EDUCATION

ELEMENTARY(Required)

NAME AND LOCATION OF SCHOOL, YEARS ATTENDED, DATE GRADUATED, SUBJECTS STUDIED

HIGH SCHOOL(Required)

NAME AND LOCATION OF SCHOOL, YEARS ATTENDED, DATE GRADUATED, SUBJECTS STUDIED

COLLEGE

NAME AND LOCATION OF SCHOOL, YEARS ATTENDED, DATE GRADUATED, SUBJECTS STUDIED

TRADE, BUSINESS OR CORRESPONDENCE SCHOOL

NAME AND LOCATION OF SCHOOL, YEARS ATTENDED, DATE GRADUATED, SUBJECTS STUDIED

THE AGE DISCRIMINATION IN EMPLOYMENT ACT OF 1967 PROHIBITS DISCRIMINATION ON THE BASIS OF AGE WITH RESPECT TO INDIVIDUALS WHO ARE AT LEAST 40 BUT LESS THAN 70 YEARS OF AGE

GENERAL(Required)

SUBJECTS OF SPECIAL STUDY OR RESEARCH WORK

SPECIAL SKILLS YOU WOULD LIKE TO LIST:

DO YOU HAVE ANY PHYSICAL DEFECTS THAT PRECLUDE YOU FROM PERFORMING ANY WORK FOR WHICH YOU ARE BRING CONSIDERED?(Required)

YES OR NO (IF YES, PLEASE DESCRIBE)

FORMER EMPLOYERS

LIST BELOW YOUR LAST FOUR EMPLOYERS, STARTING WITH THE LAST ONE FIRST

NAME & ADDRESS OF EMPLOYER, MONTH AND YEAR, SALARY, POSITION, REASON FOR LEAVING(Required)

REFERENCES

GIVE BELOW THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR

NAME, ADDRESS, BUSINESS, YEARS KNOWN(Required)

PLEASE SIGN BELOW

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION AND A CRIMINAL BACKGROUND CHECK. I UNDERSTAND THAT MISREPRESENTATION OR OMISSION OF FACTS IS CAUSE FOR DISMISSAL. FURTHER, I UNDERSTAND AND AGREE THAT MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT PREVIOUS NOTICE.

Signature:(Required)

Date:(Required)

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County Administration
Phone: 828-488-9273

Board of Elections
Phone: 828-488-6177

Building & Grounds
Phone: 828-488-9273 ext 2253

Building Inspections
Phone: 828-488-9273 ext 2268

Clerk of Court
Phone: 828-488-7400

Co-Op Extension Office
Phone: 828-488-3848

Health Department
Phone: 828-488-3198 x2002

Department of Social Services
Phone: 828-488-6921

See all Department Contacts here.

Swain County Employment Application