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Employment Application

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"Equal Opportunity Employer"

Personal Information
Name

Address



Driver's License



Employment Desired






Education
Please include the name and location of each school.








Note: Please exclude organizations where the name or character of which indicates the race, age, sex, color or national origin of its members.

Experience
List all jobs you have held in the last 10 years, beginning with your present job or most recent job. Include extra experience that may qualify you for the position. ("See attached resume" will not be acceptable in lieu of filling out this section.)


Date (mm/dd/yyyy)



Date (mm/dd/yyyy)



Date (mm/dd/yyyy)



Date (mm/dd/yyyy)



Date (mm/dd/yyyy)


US Military Service:

References
Give the names of three persons not related to you, whom you have known for at least one year.




Additional Questions










Physical Record



(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants / employees to perform essential functions. Hire may be subject to passing a medical examination and to passing skill and agility tests.)

In case of emergency, notify:

Authorization


Pre-Employment Examination


Signature


To include a Resume (Optional)
Please Send it to hradmin@wvwd.org

 
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West Valley Water District | 855 W. Base Line Road | P.O. Box 920 | Rialto, CA 92377 | Ph: (909) 875-1804 | Fx: (909) 875-1849