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Applicant Demographic Information
Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, disability or genetics.
Armed Services
Applicant References
Please give the name, address and telephone number of three references who are not related to you and are not former employers:
Education Information
Employment Experience
Employer 1
Employer 2
Employer 3
Additional Information
Please provide any additional information you feel would be helpful to us in considering your application (submit additional documents, including resume and cover letter, if necessary).
Employment Application Agreement
I certify that the answers given herein are true and complete to the best of my knowledge.
I authorize investigations of all statements contained in this application for employment as may be necessary in arriving at an employment decision. Those investigations may include, but are not limited to, verification of prior employment, verification of academic record, investigation of criminal record and other background checks. I understand that this application is not (and is not intended to be) a contract of employment.
In the event of employment, I understand that false or misleading information given in my application or interview(s), or documentation submitted in support of my application, may result in discharge. Additionally, I understand that as a public employee I will be held to a high standard of conduct, and that I am required to abide by all rules, regulations, policies and procedures adopted by the agency.
Applicant Self-Indentification Data Record
The Allen County Department of Job and Family Services is subject to certain nondiscrimination and affirmative action recordkeeping and reporting requirements which require the Agency to invite employees to voluntarily self-identify their gender and race/ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable federal laws, executive orders, and regulations, including those which require the information to be summarized and reported to the Federal Government for civil rights enforcement purposes.
Applicants are considered for all positions, and employees are treated during employment without regard to race, color, religion, sex, national origin, age, disability or genetics.
This data is for periodic government reporting and will be kept in a confidential file separate from the Application for Employment.
Referral Source
Affirmative Action Survey
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