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Employment Application

2. SUWANNEE RIVER WATER MANAGEMENT DISTRICT

4. Equal Opportunity Employer
   To be considered for employment, complete your application in its entirety.

   To be considered for employment, complete your application in its entirety.

6. Title of Position for which you are applying:*

8. First Name*

9. Last Name*

11. Address1*

13. Address2

15. City*

16. State*

17. Zip*

19. E-mail

20. County

22. Telephone*

23. Business Telephone

27. EDUCATION:

29. HIGH SCHOOL

31. Name and Address of School

33. Received:

    1. Diploma
    2. Other
    3. None

34. If Other, Specify

36. Your Name if Different While Attending School

38. COLLEGE, UNIVERSITY or PROFESSIONAL SCHOOL

39. Type of Degree Earned

41. Name of School

42. Location

43. Major/Minor

45. Attended From:
    Attended From:

46. To:
    To:

47. Credit Hours Earned (Quarter)

48. Credit Hours Earned (Semester)

50. Enter Second College, etc.

    1. Yes

51. Type of Degree Earned

53. Name of School

54. Location

55. Major/Minor

57. Attended From:
    Attended From:

58. To:
    To:

59. Credit Hours Earned (Quarter)

60. Credit Hours Earned (Semester)

62. JOB RELATED TRAINING or COURSE WORK
    (Vocational, Trade, Governmental, Business, Armed Forces)

    (Vocational, Trade, Governmental, Business, Armed Forces)

63. Type of Degree Earned

65. Name of School

66. Location

67. Major/Minor

69. Attended From:
    Attended From:

70. To:
    To:

71. Credit Hours Earned (Class)

72. Credit Hours Earned (Semester)

74. Enter Second Training, etc.

    1. Yes

75. Type of Degree Earned

77. Name of School

78. Location

79. Major/Minor

81. Attended From:
    Attended From:

82. To:
    To:

83. Credit Hours Earned (Class)

84. Credit Hours Earned (Semester)

86. LICENSURE, REGISTRATION, CERTIFICATION
    (PG, PE, EIT, Teacher Certification, CPA, etc.)

    (PG, PE, EIT, Teacher Certification, CPA, etc.)

88. License, Registration or Certification

89. Number

91. Date Received:
    Date Received:

92. Expiration Date:
    Expiration Date:

93. State Licensing Agency

95. Enter Second License, etc.

    1. Yes

97. License, Registration, Certification

98. Number

100. Date Received:
     Date Received:

101. Expiration Date:
     Expiration Date:

102. State Licensing Agency

106. EXPERIENCE
     Begin with your present or most recent job and describe all periods of employment, including self-employment. Military service, including rank and position, and periods of part-time employment and unpaid and/or volunteer service must be included. Indicate the number or employees supervised. Account for your time during any intervals of unemployment other than when attending school.

     Begin with your present or most recent job and describe all periods of employment, including self-employment. Military service, including rank and position, and periods of part-time employment and unpaid and/or volunteer service must be included. Indicate the number or employees supervised. Account for your time during any intervals of unemployment other than when attending school.

108. 1. Name of Present or Last Employer

109. Your Name if Different During Employment

111. Address

113. Telephone

114. Hours Per Week

115. Supervisor's Name

117. Your Job Title

118. From:
     From:

119. To:
     To:

121. Duties and Responsibilities

123. Reason for Leaving

124. Starting Salary

125. Ending Salary

127. 2. Name of Previous Employer

128. Your Name if Different During Employment

130. Address

132. Telephone

133. Hours Per Week

134. Supervisor's Name

136. Your Job Title

137. From:
     From:

138. To:
     To:

140. Duties and Responsibilities

142. Reason for Leaving

143. Starting Salary

144. Ending Salary

146. 3. Name of Previous Employer

147. Your Name if Different During Employment

149. Address

151. Telephone

152. Hours Per Week

153. Supervisor's Name

155. Your Job Title

156. From:
     From:

157. To:
     To:

159. Duties and Responsibilities

161. Reason for Leaving

162. Starting Salary

163. Ending Salary

165. 4. Name of Previous Employer

166. Your Name if Different During Employment

168. Address

170. Telephone

171. Hours Per Week

172. Supervisor's Name

174. Your Job Title

175. From:
     From:

176. To:
     To:

178. Duties and Responsibilities

180. Reason for Leaving

181. Starting Salary

182. Ending Salary

186. REFERENCES
     List three persons other than former employers, supervisors, or family members who are familiar with your qualifications and background.

     List three persons other than former employers, supervisors, or family members who are familiar with your qualifications and background.

188. 1. Name and Occupation

190. Address/Phone

192. 2. Name and Occupation

194. Address/Phone

196. 3. Name and Occupation

198. Address/Phone

200. RELATIVES

201. Are you related to anyone currently employed by the District?

     1. Yes
     2. No

203. NOTE:
     "Relative" is defined as father, mother, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, husband, wife, father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, stepfather, stepmother, stepson, stepdaughter, stepbrother, stepsister, half-brother, half-sister, grandfather, grandmother, or grandchildren. Employees who marry while employed at the District will be required to comply with these provisions.

     "Relative" is defined as father, mother, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, husband, wife, father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, stepfather, stepmother, stepson, stepdaughter, stepbrother, stepsister, half-brother, half-sister, grandfather, grandmother, or grandchildren. Employees who marry while employed at the District will be required to comply with these provisions.

205. VETERANS' PREFERENCE

206. Check the appropriate button.

     1. Yes
     2. No

208. To qualify for the veteran’s preference applicants must provide a copy of their DD214 with the application.

210. Upload File (DD214) here

212. CITIZENSHIP

213. Are you a U.S. citizen or are you legally authorized to work in the USA?

     1. Yes
     2. No

215. NOTE: Documentation substantiating your claim must be furnished at the time of application.
     The Suwannee River Water Management District hires only U.S. citizens and lawfully authorized alien workers. If a conditional offer of employment is made you will be required to provide proof of citizenship or authorization to work in the U.S.

     The Suwannee River Water Management District hires only U.S. citizens and lawfully authorized alien workers. If a conditional offer of employment is made you will be required to provide proof of citizenship or authorization to work in the U.S.

217. ACTIVE MILITARY SERVICE

219. Branch

220. From:
     From:

221. To:
     To:

223. BACKGROUND INFORMATION
     The District conducts a thorough background check; answers inconsistent with the background check may disqualify you from consideration.

     The District conducts a thorough background check; answers inconsistent with the background check may disqualify you from consideration.

225. Have you ever been convicted of a felony or first-degree misdemeanor?

     1. Yes
     2. No

227. If yes, of what charge(s)?

229. Place Convicted

230. Date
     Date

232. CERTIFICATION
     I am aware that any omissions, falsifications, misstatements, or misrepresentations above may disqualify me for employement consideration and if I am hired, may be grounds for termination at a later date. I understand that any information I give will be investigated as allowed by law. I consent to the release of information about my ability, employment history, and fitness for employment by employers, schools, law enforcement agencies, and other individuals and organizations to investigators, personnel staff and other authorized employees of the Suwannee River Water Management District for employment purposes. This consent shall continue to be effective during my employment if I am hired. I understand that applications submitted for District employment are public records. I certify that to the best of my knowledge and belief all the statements contained herein and on any attachments are true, correct, and made in good faith. I further agree to a drug test and a physical examination if required as a condition of employment by the District. I have been made aware that employment with the District is not guaranteed for any specific length of time and the District is not required, in it's ability to terminate employment, to list any grounds or reasons for dismissal. The Executive Director may dismiss any employee at any time.

     I am aware that any omissions, falsifications, misstatements, or misrepresentations above may disqualify me for employement consideration and if I am hired, may be grounds for termination at a later date. I understand that any information I give will be investigated as allowed by law. I consent to the release of information about my ability, employment history, and fitness for employment by employers, schools, law enforcement agencies, and other individuals and organizations to investigators, personnel staff and other authorized employees of the Suwannee River Water Management District for employment purposes. This consent shall continue to be effective during my employment if I am hired. I understand that applications submitted for District employment are public records. I certify that to the best of my knowledge and belief all the statements contained herein and on any attachments are true, correct, and made in good faith. I further agree to a drug test and a physical examination if required as a condition of employment by the District. I have been made aware that employment with the District is not guaranteed for any specific length of time and the District is not required, in it's ability to terminate employment, to list any grounds or reasons for dismissal. The Executive Director may dismiss any employee at any time.

234. File Upload

     Browse to and upload your cover letter and resume, if desired.

236. Electronic Signature*

     1. Sign

     By checking this box I am providing an electronic signature.

Leave This Blank:


238. 1. Receive an email copy of this form.
239. Email address

     This field is not part of the form submission.

240. Submit

* indicates a required field