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Enter a unique identifier consisting of the month and day of your birthday and the last 4 digits of your social security number. (MMDDSSSS)
Age information is reviewed solely for compliance with Child Labor Laws.
Give the number of your permanent resident card, work permit or employment authorization card.
If you are still employed at this job, enter today's date as the end date.
If you are still employed with this department, enter today's date as the end date.
Do not attach a copy of your driver's license to this application. A copy may be required during other phases of the selection process.
(This includes all traffic violations for which you have paid fines.)
I hereby certify that all the statements and answers set forth on the application form and/or my resume are true and complete to the best of my knowledge, and I understand that if prior to employment any such statements and/or answers are found false or that information has been omitted, such false statements or omissions will be just cause for the denial of employment. I also understand that if subsequent to employment any such statements and/or answers are found false or that information has been omitted, such false statements or omissions may be just cause for termination of my employment. Further, I understand that by requesting this information, no promise of employment is being made.
I, the undersigned, do hereby authorize the City of Springfield and/or its designated provider to conduct an investigation with respect to my application for employment and my qualifications and fitness for the position I have applied for and for employment with the City. I release the City, my former employers, and personal references from any liability or damage caused by giving and receiving information or opinions as to my employment or character. Information obtained may include residential, achievement, job performance, attendance, employment history, personal and professional references, credit reports, driving records, and criminal history records.
I agree to hold the City harmless and in no event shall the City be liable to me for special, indirect, or consequential damages for the refusal of employment due to information obtained during my background security check. Any information obtained through former employers and/or personal references will become property of the City of Springfield and will be considered confidential.
I understand that all application materials and supplemental information submitted becomes the property of the City of Springfield and will not be returned to me or any requesting agency. I waive any claims for the right to view and/or copy any information obtained through investigation of my character and employment history.
I authorize the City of Springfield, Missouri or its designated provider to perform pre-employment urine drug screening. I understand that I must successfully pass the drug screening in order to be eligible to begin employment with the City of Springfield. I understand I have the right to request a copy of the City’s Substance Abuse Policy.
I understand that if I have questions regarding any portion of the employment procedure, I have the right to contact the Human Resources Department for clarification.
Individuals with disabilities should request reasonable accommodations in accordance with the Americans with Disabilities Act prior to testing or appointment. Proof of United States Citizenship/Authorization to Work in The United States as established by the Immigration Reform Act of 1986 is a condition of employment. Pre-employment drug testing required.
This field is not part of the form submission.
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