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To submit your application please complete the form below. Fields marked with a red asterisk * are required. When you have finished click Submit at the bottom of this form.

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Cover Letter
You can use the text area for a cover letter and any supplementary information you would like to provide about your career goals, availability, best times to contact you, etc.


Contact Information


How did you hear about us?

If you were referred to us by one of our employees, who can we thank for referring you?

Personal Information

Can you, after employment, submit proof of your legal right to work in the United States?
Preferred Salary
Skills (i.e. office skills …typing, data entry, etc) or other skills

Additional Information

Are you at least 18 years of age?
Are you able to perform all the duties listed in the job announcement?
Have you ever been employed by DeKalb County Government?

If you answered yes, please provide last dates of employment, department in which you were last employed and title of the last position held with DeKalb County Government.
If no, type "N/A"

Do you have any relatives employed by DeKalb County Government?
If you answered yes, please provide relative's name, relationship and department where they are employed.
If no, type "N/A"

Have you ever been fired or forced to resign by an employer?

If yes, provide details
Have you ever been in the U.S. Military?
If yes, list the service/branch, dates entered/discharged and type of discharge.
Are you a U.S. Citizen?
Do you advocate, or have ever advocated, or are you now, or have ever been, a member of any organization that advocated the overthrow of the government of the United States, the State of Georgia, or any political subdivision thereof by force or violence?
If yes, please explain.
If no, type "N/A".
I understand that if an offer of an employment is made, a background check will be performed prior to starting work.

**Note: Pending charges and/or a conviction of a crime will not necessarily disqualify you from employment.**

Employment History - Provide employment history information below:

Responsibilities and Duties


Responsibilities and Duties


Responsibilities and Duties


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Education - Provide education information below:


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Certificates/Licenses - Provide Certificate and/or License information below:

 
 

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References - provide up to three (3) professional references:




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Driver License Info

 
   


Voluntary Equal Opportunity Questionnaire

As an equal opportunity employer, we hire without consideration to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, veteran status or disability. We invite you to complete the optional self-identification fields below used for compliance with government regulations and record-keeping guidelines.

Voluntary Self-Identification of Disability

Form CC-305   
OMB Control Number 1250-0005   
Expires 1/31/2020   

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.


How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:

• Blindness• Cerebral palsy• Multiple sclerosis (MS)
• Deafness• HIV/AIDS• Missing limbs or partially missing limbs
• Cancer• Schizophrenia• Post-traumatic stress disorder (PTSD)
• Diabetes• Major depression• Obsessive compulsive disorder
• Epilepsy• Bipolar disorder• Impairments requiring the use of a wheelchair
• Autism• Muscular dystrophy• Intellectual disability (previously called mental retardation)
 

Please Select one of the options below :

   
 
Format: MM/DD/YYYY

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the US. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.


 
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