Buffalo County Employment Application

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Buffalo County Employment Application
This application must be complete to be considered for employment.

"*" indicates required fields

Contact Information

Name*
Address*

General Employment Information

Are you eligible for work in the U.S.?*
Are You 18 years Of Age Or Older?*
Do you possess a valid drivers license?*
If the position that you are applying for requires a valid Commercial Driver's License, do you have one?

Employer History

Candidates must account for any employment history for at least the past 10 years. Begin with your most recent employment and continue with past employment.

Employer History 1 of 3

Address
(mm/yyyy)
(mm/yyyy)
May We Contact Employer?*

Employer History 2 of 3

Address
(mm/yyyy)
(mm/yyyy)

Employer History 3 of 3

Address
(mm/yyyy)
(mm/yyyy)
If you've had more than 3 jobs in the last 10 years, please use the space below to enter additional jobs.
Click the + button on the far right to add more rows.
Employer Name
Address
Dates of Employment
Your Title(s)
Duties
 

Education

Education History - List High School and any post High School education. Click the + button on the far right to add additional high schools, colleges, universities, technical colleges, or trade schools
Click the + button on the far right to add additional high schools, colleges, universities, technical colleges, or trade schools
Full Name of School
Major Subject
Highest Grade Or Year Completed
Did you graduate?
Degree Earned
 

Additional Information

Include expiration, if any

References

List 3 references that we may contact who are NOT related to you.*
Click the + button on the right to add additional references.
Name
Occupation Business Phone Number
Phone
Email
Title/Relationship
 
If you have an electronic version (Word, PDF, etc.) of your resume, you may attach it here.
Accepted file types: doc, docx, pdf, jpg, gif, png, Max. file size: 50 MB.

Questions

Have you ever been employed by Buffalo County before?*
Do you have any relatives working for Buffalo County or serving on any Buffalo County boards or committees?*
How did you hear about this vacancy?*

Have you ever been convicted of offenses that would be directly related to the particular job for which you are applying? (A conviction will not necessarily preclude you from employemnt. Wisconsin Fair Employment Act Statutes sections 111.31 to 111.395 prohibits discrimination because of criminal record or pending charge, unelss the record or charge substantially relates to the circumstances for the particular job or licensed activity.)*
According to Wisconsin Statutes 19.36 (7)(a), applicants for public employment can choose to have their application witheld from open records and possible publication by area news media. If an applicant is selected as a finalist for the public position and the applicant is interviewed with other finalists, the name and other pertinent information will become public record and may be used by the news media. Please indicate by checking below if you wish to have your name remain confidential initially.
Federal law requries Buffalo County to verify the identity and work authorization of all individuals hired on or after June 1, 1987. Are you legally eligible for employment in the United Stated?*

Notification and Agreement

Applicant Statement

I certify that my answers, including attachments, are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that if hired I may be released from employment. I agree that County of Buffalo shall not be held liable in any respect if my employment is terminated because of false, incomplete or misleading statements, answers or omissions made by me in this application.

I also authorize pertinent companies, educational institutions, current and previous employers, municipalities, licensing authority, medical institutions, or persons to give to County of Buffalo any information requested regarding my employment, character, experience and qualifications, and/or suitability for employment with County of Buffalo including a check of my fingerprints and police record for the purpose of considering my suitability for hire. I hereby forever release, discharge and covenant not to sue any person or organization for any result of providing, obtaining or acting upon such information. I understand that such information is sought with confidentiality and will not be released to me in any form whatsoever.

I understand that County of Buffalo may require me to successfully complete a pre-employment substance test as a condition of employment and that continued employment may be based on the successful completion of similar tests.

I understand that County of Buffalo may as part of the hiring process request an investigative consumer report from a third-party entity or agency including information concerning my character, general reputation, personal characteristic, credit records, and mode of living. I may make a written request to County of Buffalo to provide me with additional information regarding the nature and scope of any such report.

I understand that employment with County of Buffalo is "at will" and nothing in the interview or hiring process, this application, or County of Buffalo policies are intended to create an employment contract between myself and County of Buffalo. Employment may be terminated by either party at any time for any reason with or without notice.

I hereby release an individual or institution from any and all liability for damages of whatever kind, which may at any time result from me, my heirs, or family because of the compliance within this authorization. In addition, a copy of this authorization is as valid as the original and should be recognized as such.

I understand that County of Buffalo will contact my current employer only if I am a finalist, and that County of Buffalo will notify me prior to contacting my current employer.

County of Buffalo considers applicants for positions without regard to age, sex, race, creed, color, national origin, ancestry, disability, marital or veteran status, sexual preference, arrest and conviction record, or any other legally protected status, except where requirements constitute a bona fide occupational qualification.
DO NOT SUBMIT UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT

Voluntary Self-Identification Questions

Completion of these questions is voluntary. The County of Buffalo is an Affirmative Action and Equal Employment Opportunity employers and is committed to a policy of nondiscrimination and compliance with employment laws. In an attempt to judge the effectiveness of our recruitment efforts for affirmative action, we invite you to provide us with the following information. THis information will be removed rom your application. The information is used for statistical purposes only and will not be used in the decision to hire or promote. Failure to disclose the data will have no effect on hiring decisions.
Gender
Race/Ethnicity
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