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2. Applicant Information
4. Applying for:
   -- Select One --Administrative Assistant
6. Type of Employment*

   1. Full Time
   2. Part Time
8. Last Name*
9. First Name*
10. Middle Initial
12. Mailing Address*
14. City*
15. State*
16. Zip*
18. Home Phone Number*
19. Cell Phone Number
21. Email
25. Education
27. High School
29. Name of High School*
31. Location*
32. Diploma/GED Certificate
    -- Select One --YesNo
34. College/University
36. Name of College/University
38. Location
39. Number of Years Completed
41. Major or Coursework
42. Degree/Certificate
44. Graduate/Professional
46. Name of Graduate/Professional Institution
48. Location
49. Number of Years Completed
51. Major or Coursework
52. Degree/Certificate
54. Business/Technical
56. Name of Business/Technical School
58. Location
59. Number of Years Completed
61. Major or Coursework
62. Degree/Certificate
64. Other Education
68. Skills
70. Computer Skills

    1. Microsoft Word
    2. Excel
    3. PowerPoint

    1. Publisher
    2. Outlook
    3. Web Browser

    Check all that apply
72. Other Skills
76. Languages Other than English
78. Language
    Please indicate if you speak, write, and/or read this language.
80. Language
    Please indicate if you speak, write, and/or read this language.
84. Employment History
    List your present or most recent position first. "See Attached Resume" will not be accepted in lieu of completing this section. Include all part-time or volunteer work if applicable to the position you are applying for.
86. Name of Employer
88. May we contact this employer for a reference?

    1. Yes
    2. No
90. Mailing Address
92. City
93. State
94. Zip
96. Phone
97. Your Position
99. Duties
101. Immediate Supervisor's Name
102. Position
104. Date You Started & Left
     Date You Started & Left Start Date

     —

     Date You Started & Left End Date
105. Reason for Leaving
107. Name of Employer
109. May we contact this employer for a reference?

     1. Yes
     2. No
111. Mailing Address
113. City
114. State
115. Zip
117. Phone
118. Your Position
120. Duties
122. Immediate Supervisor's Name
123. Position
125. Date You Started & Left
     Date You Started & Left Start Date

     —

     Date You Started & Left End Date
126. Reason for Leaving
128. Name of Employer
130. May we contact this employer for a reference?

     1. Yes
     2. No
132. Mailing Address
134. City
135. State
136. Zip
138. Phone
139. Your Position
141. Duties
143. Immediate Supervisor's Name
144. Position
146. Date You Started & Left
     Date You Started & Left Start Date

     —

     Date You Started & Left End Date
147. Reason for Leaving
151. References
153. Name
155. Mailing Address
157. City
158. State
159. Zip
161. Phone
162. Occupation
164. Name
166. Mailing Address
168. City
169. State
170. Zip
172. Phone
173. Occupation
175. Name
177. Mailing Address
179. City
180. State
181. Zip
183. Phone
184. Occupation
188. Additional Information
190. If hired, can you present evidence of eligibility to work in the United States?*

     1. Yes
     2. No
192. Are you willing to relocate?*

     1. Yes
     2. No
194. Do you have a valid driver's license?*

     1. Yes
     2. No
195. If yes, which class of driver's license do you have?

     1. A
     2. B
     3. C
197. Medical: Do you agree to take a medical exam and/or drug test at company expense related to the essential requirements of the position?*

     1. Yes
     2. No
199. Are you able to perform the duties of this job for which you are applying, either with or without reasonable accommodations?*

     1. Yes
     2. No
201. How were you referred to us?
203. Additional Remarks
     We appreciate your interest in seeking employment with Monte Vista Water District. Please feel free to make any additional remarks in the space provided or attach any additional information that would be helpful in evaluating your qualifications.
205. File Upload
206. File Upload
208. By submitting this form, I hereby certify that the information submitted by me on this employment application and all other documents submitted are true and complete. I understand that any false information, omissions, or misrepresentations of material facts may disqualify me from employment with the Monte Vista Water District, and if employed, my employment may be terminated at any time.
     
     I understand that an employment offer is contingent on successful completion of a background check, drug screen and physical examination, at District expense, to identify that I am able to perform the essential job functions for the position that I have applied for, with or without reasonable accommodation. I authorize the release of such information to Monte Vista Water District of my previous employers or other persons having information concerning my records.
     
     In consideration of my employment with Monte Vista Water District, I understand that I must comply with the rules, regulations, policies and procedures of the District. I understand and agree that if I am employed as a result of this application; my employment will be "at-will," which may be terminated by either the District or me at any time, with or without cause.
Leave This Blank:


210. 1. Receive an email copy of this form.
211. Email address

     This field is not part of the form submission.

212. Submit

* indicates a required field