Skip to content
Toggle Navigation
Home
Community
Education
Fire Department
Animal Control
Library
Parks and Recreation
City Departments
Senior Center
Places to Stay
Business
Economic and Industrial Development
Airport
Chamber of Commerce
Business Permits and Licenses
Government
City Council
Agendas and Minutes
Development Services
Frequently Called Numbers
Potosi Police Department
Ordinances
How Do I?
Pay a Utility Bill
Subscribe for Emergency Alerts
Toggle Navigation
Home
Community
Education
Fire Department
Animal Control
Library
Parks and Recreation
City Departments
Senior Center
Places to Stay
Business
Economic and Industrial Development
Airport
Chamber of Commerce
Business Permits and Licenses
Government
City Council
Agendas and Minutes
Development Services
Frequently Called Numbers
Potosi Police Department
Ordinances
How Do I?
Pay a Utility Bill
Subscribe for Emergency Alerts
Toggle Navigation
Home
Community
Education
Fire Department
Animal Control
Library
Parks and Recreation
City Departments
Senior Center
Places to Stay
Business
Economic and Industrial Development
Airport
Chamber of Commerce
Business Permits and Licenses
Government
City Council
Agendas and Minutes
Development Services
Frequently Called Numbers
Potosi Police Department
Ordinances
How Do I?
Pay a Utility Bill
Subscribe for Emergency Alerts
Application
Application
Daniel_F
2023-09-08T15:51:50-05:00
Equal access to programs, services and employment opportunities is available to all persons without regard of sex (including pregnancy), race, color, religion, national origin, citizenship age, disability, genetic information, or any other basis protected by federal, state, and/or local law.
In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonable accommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonable accommodations include making a change to the application process ; providing written materials in an alternate format such as braille, large print, or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions
Name
(Required)
First
Middle
Last
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Email
(Required)
Phone
(Required)
Position applied for
(Required)
Shift Preferred
(Required)
1
2
3
Any
Special training or skills (languages, machine operation, etc.) that would benefit you in the job for which you are applying.
(Required)
Would you accept full-time work?
(Required)
Yes
No
Would you accept part-time work?
(Required)
Yes
No
On what date would you be available for work?
(Required)
MM slash DD slash YYYY
Have you ever been employed here?
(Required)
Yes
No
If yes, dates
Are you lawfully authorized to work in the United States?
(Required)
Yes
No
If you are under 18 years old, can you furnish a work permit if required?
(Required)
N/A
Yes
No
Are you able to perform the essential functions of the job for which you are applying (with or without appropriate accommodation)?
(Required)
This question is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability. particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.
Yes
No
Need more information about the job's essential functions to respond
Educational Background
Name of School (Include City and State)
(Required)
Years Completed
(Required)
Completed
(Required)
Diploma
GED
Degree
Certification
Other
Explain
GPA Class Rank
Major/Minor
Name of School (Include City and State)
Years Completed
Completed
Diploma
GED
Degree
Certification
Other
Explain
GPA Class Rank
Major/Minor
Name of School (Include City and State)
Years Completed
Completed
Diploma
GED
Degree
Certification
Other
Explain
GPA Class Rank
Major/Minor
Employment History
Starting with your most recent employer, provide the following information. You may include any verified work performed on a volunteer basis.
Employer
(Required)
Phone
Address
(Required)
Street Address
City
State / Province / Region
Starting job title/final job title
(Required)
Starting Date
(Required)
MM slash DD slash YYYY
Ending Date
MM slash DD slash YYYY
Immediate supervisor and title (for most recent position held)
May be contact this reference?
Yes
No
Later
Email
Summarize the type of work performed and job responsibilities.
(Required)
Second Employer
Employer
Phone
Address
Street Address
City
State / Province / Region
Starting job title/final job title
Starting Date
MM slash DD slash YYYY
Ending Date
MM slash DD slash YYYY
Immediate supervisor and title (for most recent position held)
May be contact this reference?
Yes
No
Later
Email
Summarize the type of work performed and job responsibilities.
Third Employer
Employer
Phone
Address
Street Address
City
State / Province / Region
Starting job title/final job title
Starting Date
MM slash DD slash YYYY
Ending Date
MM slash DD slash YYYY
Immediate supervisor and title (for most recent position held)
May be contact this reference?
Yes
No
Later
Email
Summarize the type of work performed and job responsibilities.
Applicant Statement
Do not sign until you have read the above applicant statement
I certify that I have read, fully understand and accept all terms of the foregoing Applicant Signature.
Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
CAPTCHA
Page load link
Go to Top