Application for Employment - Washington City Utah

Employment Application

Please fill out completely, all fields required unless otherwise noted
Resumes may be submitted as an attachment, but are not accepted in lieu of employment application. A separate application is required for each position

Washington City is an Equal Opportunity Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job-related medical condition or handicap.

Applicants requiring accommodations to the application and/or interview process should contact the Human Resources Department.

PLEASE NOTE: Form may time out if left too long before submitting, please have all your information ready before filling out.

Position Applying For:

Contact Information:

Full Name:
Zip Code*: (*Please make sure city appears after zip code entry)
Email Address:
Verify Email Address:
Phone Number (10 digit):

General Questions:

Are you 16 years or older? Yes No

If the position you are applying for is hazardous in nature, including but not limited to working with or around heavy equipment or hazardous material, are you 18 years of age or older? Yes No

Do you have a valid driver's license? Yes No

Have you ever filed an application with us before? Yes No

Have you ever been discharged or forced to resign from any position? Yes No

Are you currently employed? Yes No

Are you currently on "lay-off" status and subject to recall? Yes No

Can you travel if the job requires it? Yes No

Are you related to any person employed by Washington City? Yes No

Have you ever resigned from or otherwise left any employment while allegations of misconduct or harassment on your part were pending or under investigation? Yes No


Available to work: (Check all that apply): Full Time Part Time Shift Work Temporary

On what date would you be first available for employment?

Education History:

Type of Institution:

Degree or Study Course:

Did you graduate? Yes No
+Add Another [up to 5]

Employment History:

Start with your present or most recent job. Include military service assignments and volunteer activities. Exclude organization names, which indicate race, color, religion, sex, or national origin.

Currently Employed
Zip Code:
Starting Wage:
Ending Wage:

Reason For Leaving:

+Add Another [up to 3]


List job related professional, trade, business or civic activities, licenses, certificates and offices held:
Other qualifications and skills:
List technology, equipment, and software skills:
State any additional information you feel may be helpful in considering your application:

Are you capable of performing, in a reasonable manner, with or without reasonable accommodation, the activities involved in the job for which you have applied? Yes No
Optionally, list any languages you read/speak other than English:


Zip Code:
Phone Number:

+Add Another [Provide at least 3, up to 5 Total]

Attach Resume (Optional but desired):

Choose Attachment Method: Upload a PDF Copy Copy into Text Field
No Resume

Applicant's Statement

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at the employment decision. I understand that this application 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) may result in discharge. I understand also that I am or maybe required to undergo alcohol and/ or drug testing, as a condition of employment, as well as, abide by all City rules, regulations, and personnel policies.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with the City is of an "at will" nature, which means that I (as the "Employee"") may resign at any time and the City (as the "Employer") may discharge me at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed or modified by any written document or by conduct unless such change or modification is specifically approved in writing by an authorized agent of the City.

My signature below authorizes Washington City to conduct a background investigation and authorizes any applicable party contacted by the City to release such information to the City in connection with my application for employment. Specifically, I authorize release of information to the City from previous employers (as listed herein), from references (as I have provided) and applicable governmental agencies/ sources, and I release and waive any claims against such previous employers, references, governmental agencies/sources and Washington City, for the release and use of such information. If required for any position for which I am applying, the background investigation may include information regarding criminal or civil legal actions, and motor vehicle reports (driving records) obtained from applicable sources, including previous employers. I understand that such information will be considered with my qualifications for employment with the City.

To sign, type your full name:

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Washington City Utah | (435) 656-6300
111 North 100 East | Washington, Utah 84780 [map]
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