Application for Employment | City of Mission

In compliance with Federal and State equal employment opportunity laws, it is the policy of City of Mission to provide employment, training compensation promotion, and other conditions of employment based on qualifications, without regard to race, color, religion, gender, national origin, age, veteran status, disability or genetic information. The City of Mission is an Equal Opportunity Employer.

Date of Application*

Position Applied For:*

(One application per position)

Name*

First Middle Last

Maiden Name, or Other names by which you have been known

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Home Phone*

Cell Phone*

Other Phone*

Referral Source:

Newspaper Advertisement
City of Mission Website
City Employee
City Volunteer
Friend
Employment Agency
Texas Workforce Solutions
Walk-In
Other

Are you legally eligible to work in the United States?*

Yes
No

(Proof of citizenship or immigration status will be required upon employment)

Are you at least 18 years of age?*

Yes
No

Are you available to work:*

Full Time
Part Time
Shifts

Date available for work:*

Have you filed an application or been employed with the City of Mission before?*

Yes
No

If yes, when?*

Have you ever been convicted of any misdemeanor or felony excluding minor traffic offenses?*

Yes
No

If yes, please describe the nature of the charge, the date of the offense, the date of the conviction, the location or jurisdiction, and the punishment assessed (probation/prison).

Note: A Criminal Background Check will be conducted on all prospective employment applicants. A criminal record does not constitute a bar to employment. Factors such as age at the time of the offense, rehabilitation efforts, how recent and seriousness of the crime will be taken into account.

Do you have a valid Texas Driver's License?

Yes
No

If the position for which you are applying requires operation of a motor vehicle, list any traffic violations you have incurred during the past five (5) years:

List all licenses you hold (Drivers, CDL, Electrician, etc.)

Type	Issuing Agency	License Number	Expiration Date

Note: Driver's License records and other licenses will be investigated where essential and job-related.

Are you related by blood or marriage to any member of the City Council or any person(s) now employed by the City of Mission?*

Yes
No

If yes, please identify below:

Name	Relation	Department	Job Title

Employment Record

List Below Each job held. Start with your most recent employment. Include military service, full or part-time, summer jobs, volunteer activities, etc. Note: Previous employers may be contacted to verify employment record.

Name of Employer

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Employment

(month/year)

Title of Position

Salary

Provide salary information, including starting and ending amounts.

Reason for Leaving

Name of Immediate Supervisor

May we contact your current/previous supervisor?*

Yes
No

Description of duties, responsibilities, and accomplishments:

Employer 2

Name of Employer

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Employment

(month/year)

Title of Position

Salary

Provide salary information, including starting and ending amounts.

Reason for Leaving

Name of Immediate Supervisor

May we contact your current/previous supervisor?*

Yes
No

Description of duties, responsibilities, and accomplishments:

Employer 3

Name of Employer

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Employment

(month/year)

Title of Position

Salary

Provide salary information, including starting and ending amounts.

Reason for Leaving

Name of Immediate Supervisor

May we contact your current/previous supervisor?*

Yes
No

Description of duties, responsibilities, and accomplishments:

Education

Select Highest Grade Completed

Education Completed

List Grade School, as well as any College, Business or Trade School

Name of School	Address	City, State, Zip	Did you graduate?

Certificates or Licenses of Professional or Vocational Competence:

(Please attach photocopies)

File

Special Skills and Qualifications

Summarize special skills and qualifications acquired from employment or other experience.

References

List name, address, and phone number of three (3) references, other than relatives or previous employers, who have personal knowledge of your character, experience and ability.

List*

Name	Mailing Address	City/State/Zip	Telephone Number

Applicant's Statement of Certification

I hereby certify that the information given herein is true and complete. I understand and agree that any misrepresentation, falsification or omissions shall be sufficient grounds for rejection of my application and if employed, sufficient grounds for immediate dismissal.

I hereby authorize the City of Mission to fully investigate my record and work qualifications either before or after my employment with the City of Mission and to facilitate such investigation. I also hereby authorize any persons, office, agency or source, having information and knowledge about my personal, employment, military, educational, driving record, criminal, credit or financial history, prior work related injury information, physical screening, drug screening and other related matters as may be necessary in arriving at an employment decision, to furnish and release such information to the City of Mission. I hereby release employers, schools, agencies or persons and the City of Mission from all liability in responding to inquiries in connection with my application.

I understand that once a conditional job offer of employment is received, that I will submit to a pre-employment drug, physical and pre-placement screening, and any other applicable job related testing or screening that is required as a condition of employment. I further understand that I must satisfactorily pass all testing required.

In consideration of my employment, I agree to conform to the City of Mission's regulations. I understand and agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time. I also understand and agree that the terms and conditions of my employment may be changes, with or without cause, and with or without notice, at any time by the City of Mission.

I hereby understand and acknowledge that, any employment relationship with the City of Mission is of an "at will" nature, which means if an employee decides to quit, he or she is not required to give reason or notice. It also means any employee may be removed by the City Manager, by the head of the department or by other appointing officer at any time in accordance with applicable law. In submitting the application, I understand that it becomes the property of City of Mission and will not be returned.

Name

First Last

Date

Applicant please note: All qualified applications submitted to the Human Resources Department will be applicable for the specific position being applied for and will remain on an "active" status until that vacancy has been filled.

Affirmative Action Form

Government agencies require reports about status of applicants. This data is for analysis and affirmative action only. Cooperation is voluntary. Failure to supply this information will not jeopardize or adversely affect any consideration that you might receive for employment, or any later advancement in employment.

Sex

Male
Female

Race/Ethnicity

American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Hispanic or Latino (White race only)
Hispanic or Latino (All Other Races)

Are you a Veteran?

Yes
No

Please identify where you learned about an employment opportunity with this organization.

Newspaper Ad
Walk-In
Employee referral
State Employment Service
Recruiter
Temporary service
Other

If other, please specify