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Job Application

  1. Have you ever worked for the City of Healdsburg?

  2. Are you related to any person employed by the City of Healdsburg?

  3. Are you a United States citizen, or an alien authorized to work in the United States?

  4. Have you ever been convicted as an adult or any violation of the law?

    You should exclude all violations under $300 and those which have been expunged or otherwise removed from your record. Also, exclude any convictions more than two years old for violations of Health and Safety Code Sections 11357 (b) or (c), 11360 (b), 11364, 11365 and 11550 as related to marijuana offenses. A conviction is not necessarily a bar to employment and each case will be given individual consideration. A failure to list all convictions other than those excluded above, however, may disqualify you from further consideration.

  5. EDUCATION AND TRAINING

  6. Do you have a high school diploma, GED, or California High School Proficiency Certificate

  7. Degree Awarded

  8. Degree Awarded

  9. Degree Awarded

  10. THIS SECTION MUST BE FILLED OUT

    You may attach a resume or other relevant documents to further describe your qualifications, however, a resume in-lieu of a completed application will not meet the requirement to submit a completed application

  11. EMPLOYMENT HISTORY

    List your work record for the last 10 years. Begin with your most recent experience. Include self-employed and U.S Military service. Describe the work you did as completely as possible. List each promotion separately. Explain any gaps between employment periods.

  12. Were you ever discharged or forced to resign form any position?

  13. Inquiry may be made of your former employers or the last school you attended regarding your performance record. May we contact your present employer?

  14. HOW DID YOU LEARN ABOUT THIS POSITION OPENING?

  15. Newspapers

  16. Other Publications

  17. Leave This Blank:

  18. This field is not part of the form submission.