Forest Preserve District of Kane County

Forest Preserve District of KaneCounty

Human Resources Department

1996 South Kirk Road, Suite 320

Geneva, Illinois60134

Tel: (630) 208-8662, Fax: (630) 232-2038

Email: ; Web:

Application for Employment

Equal Employment Policy

It is the policy and intent of the Forest Preserve District of Kane County to provide equal employment opportunities. This policy prohibits discrimination because of race, color, religion, national origin, citizenship, disability, marital status, sex, age, political association or any other similarly protected status unrelated to ability to perform essential job functions. This policy applies to all aspects of our personnel policies, programs, practices and operations. We welcome you as an applicant for employment.

Application Instructions

The Forest Preserve District of Kane County will consider all information contained in or connected with this application personal and confidential and used only in conjunction with your possible employment. Please furnish us with complete information as outlined in this form. All candidates must complete an application in order to be considered for a position. You are encouraged to attach any additional information, which you believe relates to your qualifications for the position for which you are applying. Employees hired are subject to satisfactory completion of a 6-month introductory period. Application may not be submitted electronically – original signature is required.

please print clearly and use ink

Personal Information

Last Name

First Name

Middle Initial

Street Address

City

State

Zip

Home Phone

Cell Phone

Email Address

Do you have a valid Driver’s License?

Yes No

Do you have a current Class A CDL?

Yes No

Do you have a legal right to work in the U.S.?

Yes No

Can you show proof that you are at least 18 years of age?

Yes No

How were you referred to the District?

Employee Website Newspaper Walk-in Posting Other

Have you been convicted of an offense other than a minor traffic violation in the past 10 years?

Yes No

If yes, please provide date, location, nature of conviction and disposition:

You are not obligated to disclose sealed or expunged juvenile records of convictions or arrests. A conviction will not necessarily exclude you from employment with the District. The date, nature and disposition of an offense will be considered only as it relates to the job for which you are applying.

Position(s) Applying For

Job Title: / Salary Desired:
Job Title: / Salary Desired:
Please check all that apply: Full-time Part-time Days Nights Rotating Weekends Holidays
If your application is considered favorably, what date can you start working?

Education

Highest Grade 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 Masters Doctorate
Completed: Grade School High School Undergraduate Graduate
Type of School / Name of School / Graduate / Degree(s) / Major(s)
High School/GED / Yes No
Junior College / Yes No
College/University / Yes No
Graduate School / Yes No
Technical School / Yes No
Other / Yes No
List any special training, skills, licenses and/or certifications that may qualify you for the position and their corresponding date received:
List any organizations, clubs, societies or professional memberships which relate to the job for which you are applying:

Employment History

Complete this section even if a resume is attached. Please list all employers beginning with your present or most recent employment. Include any U.S. Military service, periods of unemployment, and experience that relates to the job for which you are applying (attach additional sheets if necessary).
Employer: / City/State: / Phone:
Supervisor’s Name/Title: / Position Held:
Date From: / Date To: / Starting Salary: / Ending Salary:
Describe your duties (be specific):
List any machinery or equipment used:
Reason for leaving or looking for a new job:
May we contact this employer? / Yes No / If no, please explain:
Employer: / City/State: / Phone:
Supervisor’s Name/Title: / Position Held:
Date From: / Date To: / Starting Salary: / Ending Salary:
Describe your duties (be specific):
List any machinery or equipment used:
Reason for leaving or looking for a new job:
May we contact this employer? / Yes No / If no, please explain:

Employment History - Continued

Acceptance

I certify that the above information, including the information in my attached resume (if applicable), is true and complete. I understand that falsification or omission of information requested in this document or other documents submitted to the Forest Preserve District of Kane County (“District”) will disqualify me from further consideration for employment or, if discovered after I am hired, shall result in immediate termination.
I understand that any offer of employment will be subject to successful results of a criminal history background investigation and satisfactory completion of a pre-employment physical exam and drug screen. However, I am aware that a conviction will not necessarily exclude me from employment from the District. The date, nature and disposition of an offense will be considered only as it relates to the job(s) for which I am applying. Failure to authorize or submit to test as required will result in the withdrawal of an offer of employment. I also understand that an offer of employment will be subject to compliance with the identification and employment eligibility requirements imposed by the U.S. Immigration and Naturalization Service. I will, upon request, sign any necessary consent forms.
I authorize any person, school, current employer (except as previously noted), past employer(s), and organizations named in this application form (and accompanying resume/reference list, if any) to provide the District with relevant information and opinion that may be useful to the District in making a hiring decision. I waive and release my current and former employers and all other individuals providing information to the District hereunder from any liability that may arise as a result of providing such information to the District, and waive and release the District and its representatives from any liability for any action taken due to information provided by any current or former employer or reference.
I understand that if hired, I will be considered an “at will” employee, meaning both the District and I have the right to terminate my employment at any time with or without cause, and without prior notice or warning. In consideration of my employment, I agree to conform to the rules, regulations and procedures set forth by the District.
I acknowledge that I have read and understand all statements contained in this application, including the “at will” statement, as evidenced by my signature below. I represent and warrant and fully understand the foregoing and seek employment under these conditions.
Signature: / Date:

Page 1 of 3July 2009 bas