• Header ImageAPPLICATION FOR EMPLOYMENT

  • ALL Questions Must Be Answered Completely and AccuratelyIncomplete Forms Cannot be Processed
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  • *Required for receipt, if desired.
  • Your Social Security Number is requested for the purpose of payroll eligibility verification, processing employment benefits, applicant and employee background checks, and income reporting and will be used solely for those purposes.
  • Have you ever been convicted of, pled nolo contendere (no contest to), had adjudication withheld, been placed on probation for, or entered a pre-trial diversion program for the commission of a crime? (Include any- and all instances of the foregoing, even if adjudication was withheld.) Note: A conviction record will not necessarily prevent you from being employed. Background checks will be processed in Florida and nationally by fingerprint records. If not answered honestly, you will be automatically disqualified.
  • Have you ever been fined for a traffic violation, pled nolo contendere (no contest to), or found guilty of a traffic violation (DUI, speeding violation, failure to obey traffic signs, etc.)? (Include any- and all instances of the foregoing, even if adjudication was withheld.)
  • Notice to applicants: Pursuant to our commitment to equal employment opportunity, the City of Apopka does not discriminate in employment on the basis of race, color, religion, national origin, sex, age, citizenship, disability, marital status, or any other legally protected status.
  • EQUAL OPPORTUNITY EMPLOYERVETERAN"S PREFERENCE - DRUG TESTING REQUIREDQUALIFIED INDIVIDUALS WITH DISABILITIES MAY APPLY AND MAY BE REASONABLY ACCOMMODATEDAPPLICATIONS SUBJECT TO PUBLIC RECORDS LAW, FLORIDA STATUTES, CHAPTER 119
  • ONLINE APPLICATIONS WILL REQUIRE SIGNATURE(S) AT THE TIME OF INTERVIEW
  • *Residency Requirement for firefighters must be met within one (1) year from date of hire. A copy of a State of Florida EMT License and a State of Florida Certificate of Compliance must be attached to the application in order to be considered for a firefighter position with the City of Apopka.
     
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  • RECORD OF EDUCATION
  • DRIVERS LICENSE INFORMATION (Please answer each question)
  • All City of Apopka positions require a valid State of Florida Driver"s License (DL). (Applicants not currently holding valid FL DL may be considered on individual basis, i.e., out of state, etc., but will be required to obtain valid FL DL.)
  • PERSONAL REFERENCES (Not Former Employers or Relatives)
  • EMERGENCY INFORMATION
  • EMPLOMENT HISTORYDo not substitute resume" - unless resume" contains ALL requested information.
  • List ALL (Present and Past) employment, beginning with most recent or present position. Please complete all fields.
  • Employer #1 (present employment or if unemployed, please indicate)
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  • Employer #2
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  • Employer #3
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  • IF RESUME" IS SUBSTITUTED FOR THIS PAGE OR NECESSARY FOR ADDITIONAL EMPLOYMENT INFORMATION, ALL INFORMATION REQUESTED ON THIS PAGE MUST BE INCLUDED ON RESUME".
  • IMPORTANT: READ AND ACKNOWLEDGE
  • As a part of the normal procedure of processing an application, an investigation may be made to provide applicable information concerning character, general reputation, personal characteristics, and mode of living. As prescribed by Public Law 91.508, upon written request, information as to the nature and scope of the inquiry, if one is made, will be provided.
  • List all names used in the past, locations and circumstances (i.e., marriage, divorce, adoption, legal name changes, alias, etc.)
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  • PLEASE READ AND ACKNOWLEDGE EACH OF THE FOLLOWING STATEMENTS:
  • I hereby authorize investigation of all statements contained in this application, including criminal background and/or fingerprint checks. I authorize all previous employers and references to release any information relating to my past history and release them from any liability arising from disclosure of these facts. I understand I am expected to answer questions honestly and will be disqualified from further consideration If i do not.
  • I hereby further agree to undergo physical examination, including but not limited to the collection of a blood, urine or breath sample to be submitted for an alcohol, drug and controlled substance, or any combination thereof, abuse screening test by a physician selected by the City of Apopka, at any time before or during employment to the City and at the expense of the City. Further, I hereby consent to the release of the test results to those City officials who make employment decisions for the City. I understand that any positive result from such a test, like any other pre-employment investigation, which indicates my inability to satisfactorily perform the job for which I am applying may preclude my employment. Further, I understand that my failure to execute this voluntary consent will result in my not being further considered for employment.
  • I authorize the City of Apopka to conduct periodic investigations related to physical, driving history or any other matter deemed necessary by the City during my employment.
  • If and when employed by the City, I hereby agree to work the regular workdays, with overtime to be worked as required by the department supervisor on such days as might be required by the City.
  • I understand that the misrepresentation, omission or incorrect statement of facts called for in this application is cause for a refusal to hire me or my termination, if I am hired. I agree, if employed, to abide by all City rules and regulations, either published or in effect by usage. I understand that all employment is based on the need of the employer for such services as I may render and all such employment is at the will of the employer.
  • I understand if I work over forty (40) hours in a work week I will be compensated in accordance with the Fair Labor Standards Act, however, I will not receive extra pay if I work more than ten (10) hours in a day.
  • By submitting this application, I am authorizing the City of Apopka to make necessary inquiries regarding my character, general reputation, personal characteristics and mode of living.
  • MILITARY SERVICE
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  • Completion of the Veteran"s Preference section is Voluntary. Information provided will be kept confidential in accordance with the Americans with Disabilities Act (ADA).
  • VETERAN'S PREFERENCE APPLICATION
  • Pursuant to Chapter 295 of the Florida Statutes, in order to claim Veterans" Preference, you must complete and sign this Veterans’ Preference form and provide all required documentation from the Department of Defense (DD) and/or the Department of Veterans’ Affairs (DVA). For the purposes of this form, a veteran is defined in §1.01(14) Florida Statutes. Preference may only be provided to qualified job applicants who have participated in a selection procedure and have submitted the required form and documentation no later than the closing of the job application period. Preference will not be awarded retroactively.
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  • QUALIFYING CATEGORIES - DOCUMENTATION REQUIRED: Please mark all that apply.
  • Those disabled veterans who have served on active duty in any branch of the United States Armed Forces, have received an honorable discharge (excludes general discharge regardless of conditions), and have established the present existence of a service-connected disability that is compensable under public laws administered by the DVA; also those disabled veterans who are receiving compensation, disability retirement benefits, or disability pension by reason of public laws administered by the DVA and the DD. (15) Provide DD-214 or equivalent from the DD or DVA showing military status, dates of service, discharge type; and documentation from the DVA certifying the veteran has a compensable service-connected disability and the percentage of that disability. 
  • The spouse of a veteran who has a total disability, permanent in nature, resulting from a service-connected disability and who, because of this disability, cannot qualify for employment; also the spouse of a person missing in action, captured in line of duty by a hostile force, or forcibly detained or interned in line of duty by a foreign government or power. (15) Provide statement that applicant is still married to the veteran, certificate of marriage to the veteran, and veteran"s DD-214 or equivalent from the DD or DVA showing military status, dates of service and discharge type. If veteran is disabled, also provide documentation from the DVA certifying the veteran is totally and permanently disabled and cannot qualify for employment because of that service-connected disability. If veteran is missing in action/captured/forcibly detained, also provide documentation from the DD or DVA that the veteran is missing in action or has been captured/forcibly detained in the line of duty. 
  • A wartime veteran as defined in §1.01(14) Florida Statutes who has received an honorable discharge (excludes general discharge regardless of conditions) and who has served at least one day during a wartime period; also a veteran who has been awarded a campaign or expeditionary medal. Active duty for training may not be allowed for eligibility under this paragraph. (10) Provide copy of DD-214 or equivalent from the DD or DVA showing military status, dates of service and discharge type; and campaign or expeditionary medal, if applicable. 
  • The unremarried widow or widower of a veteran who died of a service-connected disability. (10) Provide statement that applicant is unremarried, certificate of marriage to the veteran, veteran"s DD-214 or equivalent from the DD or DVA certifying the service-connected death, and veteran’s death certificate. 
  • The mother, father, legal guardian, or unremarried widow or widower of a member of the United States Armed Forces who died in the line of duty under combat-related conditions, as verified by the DD. (10) If the applicant is the mother, father or legal guardian, provide veteran"s DD-214 or equivalent from the DD or DVA certifying the service-connected death of the veteran under combat-related conditions, the veteran"s death certificate, and court document(s)establishing legal authority of guardian. If the applicant is the unremarried widow or widower, provide statement that applicant is unremarried, certificate of marriage to the veteran, veteran"s DD-214 or equivalent from the DD or DVA certifying the service-connected death of the veteran under combat-related conditions, and veteran’s death certificate.
  • A veteran as defined in §1.01(14) Florida Statutes who has received an honorable discharge (excludes general discharge regardless of conditions). Active duty for training may not be allowed for eligibility under this paragraph. (5) Provide DD-214 or equivalent from the DD or DVA showing military status, dates of service and discharge type. 
  • A current member of any reserve component of the United States Armed Forces or the Florida National Guard. (5) Provide Statement of Service or equivalent signed by or at the direction of the adjutant, personnel officer or commander of reserve/guard unit stating the dates of military service/current military service.
  • Important Notice:  Chapter 295 of the Florida Statutes sets forth certain requirements for public employers to accord preferences in appointment, retention and promotion to certain qualified servicemembers/veterans and certain spouses/family members of these servicemembers/veterans. Preference in appointment and employment requires that a preferred applicant be given preference at each step of the employment selection process, but does not require the employment of a preferred applicant over a non-preferred applicant who is the most qualified for the position. An applicant eligible for Veterans’ Preference who believes he or she was not afforded employment preference in accordance with Chapter 295 may file a complaint with the Department of Veterans" Affairs at 9500 Bay Pines Blvd., Room 214, St. Petersburg, Florida 33708, requesting an investigation. When the applicant has received notice of a hiring decision from a covered employer, the complaint shall be filed within 21 calendar days from the date notice is received by the applicant and/or as otherwise provided in Florida Administrative Code R. 55A-7. Also, § 295.07(4) Florida Statutes provides exemptions to Veterans’ Preference.  
  • Acknowledgement of Applicant (required): I, the undersigned qualified servicemember/veteran or spouse/family member of a qualified servicemember/veteran, acknowledge that I have provided true and correct information on this form and all related documentation, and that I have read and understand the rights expressed in the foregoing notice.
  • Wartime Eras eligible for Veterans" Preference:Operation New Dawn - September 1, 2010 to TBDOperation Iraqi Freedom - March 19, 2003 to TBDOperation Enduring Freedom - October 7, 2001 to TBDPersian Gulf War - August 2, 1990 to January 2, 1992Vietnam Era - February 28, 1961 to May 7, 1975Korean Conflict - June 27, 1950 to January 31, 1955World War II - December 7, 1941 to December 31, 1946
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  • NOTE: PLEASE DO NOT EXIT - Upon submission of this form, redirection to a data collection sheet will occur - at a minimum, your name and the position for which you have applied must be entered into the data form. Your application is not complete without this form. Thank you.
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