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Bullhead City Employment Application - Contract COPY

Please correct the field(s) marked in red below:

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Human Resource Division

1255 Marina Blvd.

Bullhead City, AZ 86442

Phone: (928)763-0153   Fax: (928) 763-0113    TTY: (928) 763-0143

 

The City is an Equal Employment Opportunity Employer. It is the policy of the City to utilize the services of independent contractors without regard to race, color, sex, religion, national origin, age, political affiliation, physical or mental impairments or veteran status. In accordance with Arizona Revised Statutes 36-601.01(C), smoking is prohibited in all public places and public facilities. 

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YOU ARE APPLYING FOR  A CONTRACT POSITION. 

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PERSONAL DATA

 *
PERSONAL DATA
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DRIVERS LICENSE INFORMATION

DRIVERS LICENSE INFORMATION
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HAVE YOU BEEN KNOWN TO PREVIOUS SCHOOLS/EMPLOYERS/LAW ENFORCEMENT/REFERENCES BY ANOTHER NAME?

HAVE YOU BEEN KNOWN TO PREVIOUS SCHOOLS/EMPLOYERS/LAW ENFORCEMENT/REFERENCES BY ANOTHER NAME?
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LIST OF RESIDENCES FOR THE PAST 10 YEARS (CITIES AND STATES):

LIST OF RESIDENCES FOR THE PAST 10 YEARS (CITIES AND STATES):
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DO YOU CURRENTLY POSSESS AN ARIZONA FINGERPRINT CLEARANCE CARD?

DO YOU CURRENTLY POSSESS AN ARIZONA FINGERPRINT CLEARANCE CARD?
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IF YOU DO NOT POSSESS AN ARIZONA FINGERPRINT CLEARANCE CARD, DO OU CURRENTLY HAVE PENDING CHARGES OR HAVE YOU EVER BEEN CONVICTED OR PLEAD GUILTY TO A CRIME? 

"CRIME" means all felonies, misdemeanors, and serious driving offenses (e.g., include: DWI/DUI-Drugs, Reckless Driving) does not include minor traffic offenses.  

IF YOU DO NOT POSSESS AN ARIZONA FINGERPRINT CLEARANCE CARD, DO OU CURRENTLY HAVE PENDING CHARGES OR HAVE YOU EVER BEEN CONVICTED OR PLEAD GUILTY TO A CRIME? "CRIME" means all felonies, misdemeanors, and serious driving offenses (e.g., include: DWI/DUI-Drugs, Reckless Driving) does not include minor traffic offenses.
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HAVE YOU EVER WORKED OR VOLUNTEERED FOR THE CITY OF BULLHEAD CITY? 

HAVE YOU EVER WORKED OR VOLUNTEERED FOR THE CITY OF BULLHEAD CITY?

PLEASE NOTE: If hired, you will be required to undergo and pass a thorough background investigation, which will include a criminal history completed in accordance with Arizona Revised Statutes 41-1750. Any false statement or omission will be considered falsification of your employment application and grounds for immediate termination from you position or withdrawal of any offer of employment with the City of Bullhead City.

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HAVE YOU EVER WORKED OR VOLUNTEERED FOR THE CITY OF BULLHEAD CITY?

HAVE YOU EVER WORKED OR VOLUNTEERED FOR THE CITY OF BULLHEAD CITY?