New Submission

Datefield type date
Date will be captured on form submission
CITY OF AUBURN HILLS
1827 N. Squirrel Road
Auburn Hills, Ml 48326
ATTENTION: HUMAN RESOURCES

INSTRUCTIONS: Please furnish complete and accurate information. Applications will be verified. You may attach a detailed resume.

1.      Filing an application does not imply that you will be interviewed or hired, but that you will be considered for vacancies in which you meet the minimum qualifications based upon your stated occupational preference.

2.      Applications are considered active for one year.

PERSONAL INFORMATION

First Name:*field type single line
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Middle Initial:field type single line
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Last Name:*field type single line
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Phone Number:*field type single line
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Email*field type email
Present Address:*field type single line
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City:*field type single line
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State:*field type drop-down
Zip Code:*field type single line
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Have you ever worked for the City of Auburn Hills?*field type radio button
Have you ever worked for the City of Auburn Hills?YesNo
Department:*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Separation Date:*field type date
Reason for Separation:*field type multi line
Have you ever served in the US Armed Forces?*field type radio button
Have you ever served in the US Armed Forces?YesNo
Branch of Service:*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Have you ever been court-martialed or convicted of violating any laws within the last (7) seven years (excluding minor traffic fines)?*field type radio button
Have you ever been court-martialed or convicted of violating any laws within the last (7) seven years (excluding minor traffic fines)?YesNo
×
- Offense:*field type single line
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- Date of Conviction:*field type date
- Where? (City, State)*field type single line
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- Disposition:*field type single line
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Are you legally eligible for employment in the US?*field type radio button
(Proof of citizenship or immigration status will be required on employment.)
Are you legally eligible for employment in the US?YesNo
Are you 18 years old or older?*field type radio button
Are you 18 years old or older?YesNo
EDUCATION, SPECIAL INTERESTS, QUALIFICATIONS
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- School:*field type drop-down
  (List all schools attended) Use the Add link below to add additional schools
- School Name*field type single line
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- City/State*field type single line
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- Total Years Credit:*field type number
- Dates Attended From:*field type date
- Dates Attended To:*field type date
- Course (Major/Minor)field type single line
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- Certificate/Diploma/Degree:*field type single line
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- Year Graduated:*field type number
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List relatives working at Auburn Hills:

	Relative Namefield type single line	Relationshipfield type single line
Row 1×	Relative Namefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Relationshipfield type single line Input blocked. Maximum character limit of 4000 characters reached.	×

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Special Interestsfield type multi line

POSITION DESIRED

	Position*field type single line	Schedule*field type drop-down	Date you can begin work*field type date	Expected Salary/Rate*field type currency	Police Position?*field type drop-down	Fire Position?*field type drop-down
Row 1×	Position*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Schedule*field type drop-down	Date you can begin work*field type date	Expected Salary/Rate*field type currency $	Police Position?*field type drop-down	Fire Position?*field type drop-down	×

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Employers must make accommodations to disabled applicants and employees where the accommodation does not impose an undue hardship on the employer. Under Michigan law, disabled employees and applicants may request an accommodation of their disability by notifying the city in writing of the need for accommodation within 182 days of the date the disabled individual knows or should know that an accommodation is needed. Failure to properly notify the city may preclude any claim that the employer failed to accommodate the disabled individual under Michigan law.
EMPLOYMENT INFORMATION
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- ADDITIONAL INSTRUCTIONS: List Employment starting with your most recent employer. Account for all periods including U.S. Armed Forces service and periods of unemployment.
- Start Date (MM/YY)*field type single line
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- End Date (MM/YY)*field type single line
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- Firm Name:*field type single line
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- Address:*field type single line
  Street, City, State Zip
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- Base Earnings:*field type currency
  $
- Reason for Leaving:*field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Job Title and Duties*field type multi line
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PROFESSIONAL LICENSES/CERTIFICATIONS/TRAINING:

	Typefield type single line	Numberfield type single line
Row 1×	Typefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Numberfield type single line Input blocked. Maximum character limit of 4000 characters reached.	×

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List professional trade, business or civic activities and offices held excluding groups the name or character of which indicate race, color. religion, sex, national origin, handicap; marital or veteran status, height, weight or age.field type multi line
field type file upload
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ADDITIONAL INFORMATION

REFERENCES

Provide the names of three persons, not related to you, who have knowledge of your experience and qualifications for the position.

	Full Name/Title Position*field type single line	Email Address*field type email	Business or Occupation Phone Number*field type single line	Years Known*field type number
row 1	Full Name/Title Position*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Email Address*field type email	Business or Occupation Phone Number*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Years Known*field type number
row 2	Full Name/Title Position*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Email Address*field type email	Business or Occupation Phone Number*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Years Known*field type number
row 3	Full Name/Title Position*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Email Address*field type email	Business or Occupation Phone Number*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Years Known*field type number

Do you possess a valid Michigan Drivers License?*field type radio button
Do you possess a valid Michigan Drivers License?YesNo
Michigan Driver's License Number:*field type single line
A-Z ### ### ### ###Capital letter followed by 4 groups of 3 numbers
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Have you accumulated more than four (4) points in the last 3 years?*field type radio button
Have you accumulated more than four (4) points in the last 3 years?YesNo
Any other license endorsements?*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
State any additional information that you feel may be helpful to us considering your application:field type multi line
We are an equal opportunity employer and will not unlawfully discriminate on the basis of race, color, sex including pregnancy), religion, national origin, age, marital or veteran status, disability, familial status, genetic information, height, weight or any other protected status.

Authorizations and Understandings

Upon the signing of this application, I represent that all of the information now or hereafter given by me in support of my application is true and complete. I authorize you to verify any of the information concerning my employment, education, criminal history, credit or medical history (post-offer only), 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 as would otherwise be required under the Bullard-Palwecki Right to Know Act, 1978 PA 397. 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.
I agree that either party may terminate the employment relationship, with or without cause, at any time, and I further agree that this arrangement may only be altered in writing directed to me personally and signed by the City Manager. I agree that I shall be bound by the other rules, policies, regulations and terms and conditions of employment of the city as they are from time to time changed, and no additional obligations can be imposed on the city except those which have been acknowledged in writing, by the City Manager or its designated representatives. I hereby authorize the city to deduct from each and every period of my pay any amounts necessary to offset any damages caused by me or the value of property or money entrusted to me by, or owed by me to the city during the course of my employment.
I agree that any action or suit against the city arising out of my employment or termination of employment, including, but not limited to, claims arising under State or Federal civil rights statutes, must be brought within 180 days of the event giving rise to the claims or be forever barred. I waive any limitation periods to the contrary (Should the 180-day limitations period be found to be unreasonable and unenforceable; the period of limitations shall be the minimum reasonable time in excess of 180 days.) I further agree that if I should bring any non-statutory action or claim arising out of my employment against the city, in which the city prevails, I will pay to the city any and all such costs incurred by the city in defense of said claims or actions, including attorney fees. I further agree that my employment is conditional until such time as the results of my post offer physical (if such physical is required) are known.
I hereby consent to having a physical and/or psychological examination and/or test(s), including but not limited to drug and/or alcohol testing, conducted by a physician or other professional of the City of Auburn Hills' choice, and understand that any offer of employment is conditioned upon the results of this examination(s) and/or test(s).
Signature Date*field type date
Date will be captured on form submission
Signature*field type signature

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION

EDUCATION, SPECIAL INTERESTS, QUALIFICATIONS

List relatives working at Auburn Hills:

POSITION DESIRED

EMPLOYMENT INFORMATION

PROFESSIONAL LICENSES/CERTIFICATIONS/TRAINING:

ADDITIONAL INFORMATION

REFERENCES

Authorizations and Understandings

SUPPLEMENTAL QUESTIONS