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Select Page
Employment Application
Online Application for Employment
Step
1
of
4
25%
Which position are you applying for?
(Required)
Have you been previously employed by the OCRC?
(Required)
Yes
No
When and what position?
(Required)
At which OCRC location are you seeking employment?
(Required)
Where did you learn about this position?
Do you have a valid driver's license?
(Required)
Yes
No
Do you have a CDL Class A license?
(Required)
Yes
No
Please note that if you are applying for a position that requires a CDL, you will be asking to complete additional paperwork if contacted for an interview.
Name
(Required)
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Middle
Last
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Street Address
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
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Phone Number
(Required)
Alternate Phone Number
Email
Are you 18 years of age or older?
(Required)
Yes
No
Please list any other name(s) you have used in connection with employment, education, U. S. Military Service, or in connection with any criminal conviction or pending felony charge:
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Have you ever been convicted of a crime or are you presently charged with a felony?
(Required)
Yes
No
When and explain the circumstances, listing each separate offense and giving the date, name and location of the court, the penalty imposed, if any, and other disposition of the case.
(Required)
Have you received a disciplinary suspension within the last four years?
(Required)
Yes
No
Explain:
(Required)
EDUCATION/COURSE OF STUDY
Education History
(Required)
Type of School
Name/Location of School
Graduate Yes/No
Degree/Course of Study
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Please include high school, college/university and/or any other schooling attended.
Describe courses taken, and licenses or certifications obtained that may be particularly useful to the position for which you are applying:
(Required)
EMPLOYMENT HISTORY
Notice to Applicant: You are hereby informed that the employment information provided below may be used, and your prior employers may be contacted for the purpose of investigating your background. Please include 10 years of employment history. Any gaps in employment in excess of one month must be explained. Please list your employment history starting with the most recent.
Employer
(Required)
Job Position
(Required)
Address
(Required)
Supervisor
(Required)
Phone
(Required)
Start Date
(Required)
Month
Day
Year
End Date
Month
Day
Year
Salary
Reason for Leaving
(Required)
Specific Duties
(Required)
Were you discharged or did you resign in lieu of discharge?
(Required)
Yes
No
Explain:
(Required)
Do you have additional employment history?
(Required)
Yes
No
Employer
(Required)
Job Position
(Required)
Address
(Required)
Supervisor
(Required)
Phone
(Required)
Start Date
(Required)
Month
Day
Year
End Date
(Required)
Month
Day
Year
Salary
Reason for Leaving
(Required)
Specific Duties
(Required)
Were you discharged or did you resign in lieu of discharge?
(Required)
Yes
No
Explain:
(Required)
Do you have any other employment history?
(Required)
Yes
No
Employer
(Required)
Job Position
(Required)
Address
(Required)
Supervisor
(Required)
Phone
(Required)
Start Date
(Required)
Month
Day
Year
End Date
(Required)
Month
Day
Year
Salary
Reason for Leaving
(Required)
Specific Duties
(Required)
Were you discharged or did you resign in lieu of discharge?
(Required)
Yes
No
Explain:
(Required)
Resume, references, and/or additional employment history can be attached.
Drop files here or
Select files
Accepted file types: pdf, doc, docx, jpg, Max. file size: 3 MB.
List any friends or relatives working for the Ottawa County Road Commission:
Name
Relationship
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Certification
By signing this application, I certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I understand and agree that any misrepresentation of information may be sufficient cause for rejection of this application, or if employment has commenced, grounds for immediate dismissal.
I understand and agree that Ottawa County Road Commission may make a full and complete investigation of my personal and/or employment history. I authorize any former employer, person, firm, corporation, school, government agency, or other entity to provide the Commission with any information they may have regarding me. In consideration of the Commission’s review of this application, I release the Commission and all providers of any information from any liability that may arise as a result of furnishing and receiving this information. I understand and agree any employment offer or continued employment shall be conditional on the receipt of satisfactory references as determined by the Commission.
I understand and agree that I may be required to undergo a post-offer physical examination permitted by law and I agree to disclose completely all information lawfully requested at such examinations, and that I will cooperate in such lawful medical tests (drug screening and/or alcohol test). I waive and release and promise not to make any claims against the Commission (or any testing agency retained by the Commission) or fromlawful decisions made regarding my employment or termination of my employment based upon the results of such testing or analysis.
I specifically authorize release of any records of prior criminal convictions and/or pending felony charges, and motor vehicle records and I hereby release Ottawa County Road Commission from any and all actions and claims which may be sustained by me from the release and use of the information. I agree that I will not commence any action or suit relating to my employment with the Commission (or termination of the employment) more than six (6) months after the termination of my employment, and I agree to waive any statute of limitations to the contrary. I understand that this means that even if the law would give me a right to wait a longer time to make a claim, I am waiving that right and that any claims not brought within six (6) months after my employment ends will be barred.
Full Name
(Required)
Applicant Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
Future employment opportunities will require a new employment application.
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