Utility Maintenance Technician Application

Utility Maintenance Tech Employment Application

  • Application Date
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  • Name *
  • Phone *
    - -
  • Street Address *
  • GENERAL INFORMATION

  • Have you ever been employed with Cleveland County Water?
  • Are you related by blood or marriage to any CCW employee or Commissioner?
  • Are/were you a member of the U.S. Armed Forces?
  • Have you ever been convicted of or plead guilty to a crime?
  • NOTE: A conviction will not automatically bar you from employment.
  • EDUCATION

    (Give complete education history below)
  • Did you graduate?
  • If no, do you have a High School Equivalency (GED)?
  • Name City and State Degree/Certification Received
    College or University
    Graduate or Professional
    Other Education
  • EMPLOYMENT HISTORY

    Record your complete work history in the spaces below. Begin with your current or most recent employer first. Attach additional sheets as needed. Be sure to account for gaps in your employment history. Please complete the employment history even if a resume is attached. Related volunteer experience should also be listed.
  • A. CURRENT OR MOST RECENT EMPLOYMENT

  • From
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  • To
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  • Phone
    - -
  • Address
  • FULL-TIME OR PART-TIME?
  • If currently employed, may we contact?
  • B. NEXT MOST RECENT EMPLOYER

  • From:
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  • To:
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  • Phone
    - -
  • Address
  • FULL-TIME OR PART-TIME?
  • C. NEXT RECENT EMPLOYMENT

  • From
    / /
  • To
    / /
  • Phone
    - -
  • Address
  • FULL-TIME OR PART-TIME?
  • REFERENCES

    Please provide names and contact information for three (3) people who are not related to you and who have a definite knowledge of your ability to perform the job for which you are applying. Do not repeat the names of supervisors included in your employment history above.
  • Name
  • Phone
    - -
  • Name
  • Phone
    - -
  • Name
  • Phone
    - -
  • READ CAREFULLY BEFORE SUBMITTING

    I certify that all answers and statements on this application are true and complete. I understand that any falsification, omission, or misrepresentation of facts in this application, in connection with any aspect of the hiring process, will be cause for either the rejection of this application or for my discharge if I have been hired.

    I understand that my employment may be contingent upon my passing a physical examination. I also understand that future examinations may be required by Cleveland County Water. I am aware that Cleveland County Water requires screening for drugs as part of its pre-employment testing and that I may be required to take future examinations for drugs and/or alcohol, in accordance with Cleveland County Water policy.

    I authorize Cleveland County Water to make any inquiry or investigation deemed necessary to consider my employment application. This may include contacting former employers and criminal records check. I understand that conviction of a crime will not automatically bar my employment. I may still be eligible for employment if Cleveland County Water determines my conviction could have no bearing to the job for which I am applying.

    I authorize former employers and schools to release all information Cleveland County Water requests from them concerning my academic records, job performance, attendance, personal evaluation, or other related information. I release all parties which may provide information regarding my application from liability and/or damages.

    If my employment with Cleveland County Water terminates for any reason, I authorize Cleveland County Water to release all information and to answer any inquiries regarding my employment, performance, and the reasons for my termination.

    I understand that if I am employed my employment will include a probationary period. During and after the probationary period my employment is “at will;” it can be terminated at any time by me or Cleveland County Water. I also understand that the terms, policies, procedures, and rules of employment are not guaranteed. They are subject to change at any time by Cleveland County Water.
    Although I may be employed for a specific work schedule, I understand Cleveland County Water does not guarantee my work schedule and may alter it as necessary.

    I understand this application is current for only the specified job I am applying for. I will complete a new application should I not be hired for the applied for position if future job opportunities become available that I may be interested in.
  • SIGNATURE
  • Date
    / /
  • Security verification
    Complete the Google reCAPTCHA challenge before submitting this application.
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