Official Website of The City of Othello Washington

Employment Application

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Thank you for your interest in the City of Othello's employment opportunities.

Applications will be processed only when the City of Othello has announced a recruitment and the closing date has not passed. The City of Othello will not process unsolicited applications for employment nor will it retain applications for future consideration. The City of Othello is an Equal Opportunity Employer and does not discriminate in any employer/employee relations based on race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, genetic information, veteran status, or any other basis protected by applicable discrimination laws.

*First Name

*Last Name

*Email Address

*Phone

*Address

*City

*State/Province

*Country

*Zip Code

*Position for which you are applying

How did you hear about this opening ?

Upload Resume

________________________________________________________________________________________________________________

GENERAL

*Are you currently employed by the City of Othello?

Yes

*Can you perform the essential functions of this position with or without reasonable accommodation?

Yes

If applicable, what accommodations would be needed?

*Are you available to work evenings and weekends if necessary?

Yes

If yes, please explain:

*Have you ever been dismissed or fired from a position for any reason? (A "Yes" answer will not automatically bar you from further consideration).

Yes

If Yes, please explain

*Have you ever resigned from or quit a position while under investigation or after being informed that discipline would be taken against you, or during an appeal of a disciplinary action? (A "YES" answer will not automatically bar you from further consideration).

Yes

If Yes, please explain.

*Are you legally eligible for employment in the United States?

Yes

*Do you possess a valid Driver's License?

Yes

*Issuing State

Any applicable endorsements or restrictions?

*Do you have any relatives who work for the City of Othello?

Yes

If Yes, provide their names:

*When would you be available to start work?

_________________________________________________________________________________________________________________

EDUCATION

*What is the highest grade of elementary or secondary school completed?

If you did not complete high school, do you have a high school equivalency diploma?

Yes

State the number of years of post-secondary education

For any post-secondary education, list the name and location of the institution, units completed, dates attended, course of study, and degree/diploma/certificate obtained.

List any valid licenses or certificates of professional or vocational competence relevant to this application, including the license/certificate number and expiration date:

________________________________________________________________________________________________________________

EMPLOYMENT HISTORY--Starting with the most recent, describe ALL paid, military, and applicable volunteer experience.

MOST RECENT POSITION

Job Title

Employer Name, Address, and Phone Number

Starting and ending dates

Hours per week

Overtime eligible?

Yes

Salary Earned

Duties

May we contact this employer?

Yes

Reason for leaving

________________________________________________________________________________________________________________

PREVIOUS EMPLOYER

Job Title

Employer Name, Address, and Phone Number

Starting and Ending Dates

Hours per week

Overtime eligible?

Yes

Salary earned

Duties

Reason for leaving

____________________________________________________________________________________________________________

PREVIOUS EMPLOYER

Job Title

Employer Name, Address, and Phone Number

Starting and ending dates

Hours per week

Overtime eligible?

Yes

Salary earned

Duties

Reason for leaving

______________________________________________________________________________________________________________

For additional employers, attach a resume above or list below

________________________________________________________________________________________________________________

REFERENCES--Please list three professional references who know about your qualifications

Name

Address

Phone number

Relationship

Name

Address

Phone number

Relationship

Name

Address

Phone number

Relationship

________________________________________________________________________________________________________________

NOTICES

 If you are employed by the City of Othello, you will be required to establish your identity and authorization to work in the United States, as required by the Immigration Reform and Control Act.  The City of Othello is a smoke and drug free work place. You may be required to complete a drug test prior to employment and may be subject to random drug testing after employment (safety sensitive positions only).  If you are unable to complete the application process due to disability, the City of Othello will provide reasonable accommodations to assist you.  Please do not submit an identification photo; if needed, we will obtain one after hire.

CERTIFICATION

*By submitting this application, you are certifying the following: That the information provided by me in this application for employment is true, correct, and complete. I understand that any misstatement, failure to answer fully or omission of fact in this application may result in my not being considered in the selection process or may result in my dismissal after hire. I understand that acceptance of an offer of employment does not create a contractual obligation upon the City of Othello to continue to employ me in the future. I understand that if I receive a Conditional Offer of Employment for a position where I will have unsupervised access to children, developmentally disabled persons or vulnerable adults, the City of Othello is required to complete a thorough background check as authorized by the Child/Adult Abuse Information Act. If I am applying for an exempt position, I understand that nothing in this application or my communications with any City of Othello official is intended to create an employment contract between the City of Othello and me. For determination of my potential employment eligibility, I hereby authorize release of educational, police, criminal, employment and reference information pertinent to the position for which I am applying. I further authorize the City of Othello to rely upon and use, as it sees fit, any information received from such contacts.

I agree

RELEASE OF INFORMATION

*By submitting this application, I certify that the information given by me to the City of Othello is true and complete to the best of my knowledge. I understand that, if employed, false or misleading information may result in immediate dismissal. I further certify that I am not engaged in any outside activity or business that could be considered in conflict with the City of Othello’s interest, nor will I become engaged in such activity or business if employed. I authorize the City of Othello to solicit information regarding my character, general reputation, previous employment, and similar background information, and to contact any and all references I have given on my application. I hereby release all parties and persons connected with any such request for information from all claims, liabilities, and damages for any reason arising out of the furnishing of such information. If employed, I release the City of Othello from any liability for future references it may provide regarding my work history at the City. In consideration of my employment, I agree that my employment and compensation can be terminated with or without cause, and with or without notice at any time, at the option of either the City of Othello or myself. I understand that no representative of the City of Othello, other than the City Administrator or Mayor, has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. If employed, I further agree that if the City of Othello advances any paid leave before it has been accrued, or advances or loans me any money during the course of my employment, of if I lose, damage, or fail to return any of the City of Othello’s property, the City of Othello is authorized to deduct from my wages sufficient funds to repay such loans or advances or to replace its property.

I agree

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