The City of Washington, Indiana

Small City... Big Possibilities

Application for Employment

 Step 1 of 1

To apply for Employment, please fill out this online application. To find out what jobs are open please call 812-254-5575.

* Denotes a required field

Contact Information

*
*
Date of Application*
 Date of Application
*
*
*
*
*
*
ZIP*
-
Second portion of ZIP Code is optional.
Telephone Number*
-- ext
Cell Phone Number*
-- ext
*

Additional Information

Are you 18 years of age or older?*
Have you ever been employed with us before?*
If Yes, give date when last worked 
 If Yes, give date when last worked
Do you now or have ever had a relative employed by this City?*
 
Are you currently employed?*
May we contact your present employer?*
Are you legally eligible to work in the United States?*
Date available for work?*
 Date available for work?
*
Are you available to work - Weekday / Daytime / Saturday?*
Weekday / Evening Hours? Sunday Afternoon?*
*
Are you currently on "lay-off" status and subject to recall?*
 
 
Have you ever been arrested or convicted of a crime that has not been expunged by the court?*

Education

*
*
*
*
 
*
*
*
 
*
 
 
 
 
*
*
Experience 

Work Experience - Most Recent Employer

*
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
*
*
Telephone Number*
-- ext
Date Employment Started*
 Date Employment Started
Date Employment Ended 
 Date Employment Ended
*
 
 

Additional Employment History

*
*
*
Telephone Number*
-- ext
*
Date Employment Started*
 Date Employment Started
Date Employment Ended*
 Date Employment Ended
*
*
*
 
 
 
Telephone Number 
-- ext
 
Date Employment Started 
 Date Employment Started
Date Employment Ended 
 Date Employment Ended
 
 
 
Do you have any special skills, volunteer experience and/or training that would enhance your ability to perform the position applied for? 
 

References

*
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
Reference 1 Phone Number*
-- ext
*
*
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
Reference 2 Phone Number*
-- ext
*
*
 
 
 
ZIP 
-
Second portion of ZIP Code is optional.
Reference 3 Phone Number 
-- ext
 
 
Employement: Upon the signing of this application, I represent that all of the information now or hereafter given by me in support of my application for employment is true and complete. I authorize you to verify any of the information concerning my employment, education, driving record, criminal history, credit history or medical history with the appropriate individuals, companies, institutions or agencies and I authorize them to release such information as you require, including my prior disciplinary employment record, without any obligation to give me written notice of such disclosure. I also authorize you to release any information requested by any of my prospective or subsequent employers without any obligation to give me written notice of such disclosure. I hereby release you and them from any liability whatsoever as a result of any such inquiries and disclosures. I agree that any false information in support of my application may subject me to discharge at any time during the period of my employment. If hired, I agree I will serve at the will of the City of Washington and I agree that I shall be bound by the rules, policies, regulations and terms and conditions of employment of the city of Washington as they are from time-to-time changed with or without notice to me. I agree that either party may terminate the employment relationship, with or without cause, at any time for any reason. I agree that these arrangements may only be altered in writing directed to me personally by the Mayor of the City of Washington. I further agree that if! should bring any action or claim arising out of my employment against the City of Washington in which the City of Washington prevails, I will pay to the City of Washington any and all costs incurred by the City of Washington in defense of said claims or actions, including attorney’s fees. I further agree that my employment is conditional until such time as the results of my pre-employment physical (if such physical is required) are known.
*
If you wish to submit a resume with this required application, please email it to dneukam@washingtonin.us.