Employment Status: Full-Time
FLSA Status: Non-Exempt
Experience Required: Experience with a zero-turn mower and hand tools.
Minimum Education Requirements: High School Diploma or G.E.D.
Direct Supervisor:
Street Superintendent
Supervisory Responsibility : No
Primary Work Location: Inside and outside of all City of Nixa facilities.
Certification: Valid State of Missouri driver’s license.
Salary: $20.92-$21.97 per hour
Job Summary:
Performs a variety of operation, maintenance, and repair activities on the street, right-of-way’s, easements, and building facilities for the City of Nixa, MO.
APPLICATION FOR EMPLOYMENT Step 1 of 3
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APPLICATION FOR EMPLOYMENT “AN EQUAL OPPORTUNITY EMPLOYER”
Available to Work:
Full Time
Part Time
Seasonal
Intern
INSTRUCTIONS TO APPLICANT:
Complete all pages of this application, either by typing or printing legibly. Please sign thelast page. The application and any attachments become the property of the City of Nixa.
Name
First Last
Email
Address
Street Address Address Line 2 City State ZIP Code
Phone
1. Are you a citizen of the United States?
Yes
No
2. If no, are you permitted to work in the United States?
Yes
No
Please explain:
3. Do you have any relative(s) working for the City of Nixa, serving on the City’s administrative boards or City Council?
Yes
No
4. If yes, provide name(s) and relationship:
5. Have you ever been employed by the City of Nixa?
Yes
No
6. If yes, provide dates and department
7. Have you been known by any other name?
Yes
No
8. If yes, what name
9. Have you ever been convicted of or pled guilty to any federal, state, or municipal criminal offense? (This includes ALL TRAFFIC VIOLATIONS for which you have paid fines.)
Yes
No
10. If yes, describe in full A conviction will not automatically disqualify you from consideration. We will consider the nature of the offense in relation tothe job for which you are applying. We will also consider your record since the offense was committed.
11. Can you physically and/or mentally perform the essential job functions of the position for which you are applying?
Yes
No
12. If no, can reasonable accommodations be made which would allow you to perform the essential job functions?
Yes
No
Answers of “yes” or “no” to questions 9-12 do not automatically disqualify you from employment.
Military Service
Were you in the military?
Yes
No
Branch of Service
From MM slash DD slash YYYY
To MM slash DD slash YYYY
Duties/Special Training
Reserve (active)
EMPLOYMENT HISTORY
LIST ALL POSITIONS you have held starting with the most recent. If same employer, list different titles eachas separate employment. Employment history includes positions held, lapse of employment, and military duty. Usea blank sheet of paper if more room is needed. DO NOT indicate “See Resume.” A resume may be attached to provide supporting information, but willnot be accepted in lieu of completing this section.
Present or last employer
Telephone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employed (month and year)
Name
First Last
From MM slash DD slash YYYY
To MM slash DD slash YYYY
Name and Title of Supervisor/Reference
May we contact this employer?
Yes
No
State job title and give a brief description of duties.
Reason for leaving:
Employer
Telephone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employed (month and year)
From MM slash DD slash YYYY
To MM slash DD slash YYYY
Name and Title of Supervisor/Reference
May we contact this employer?
Yes
No
State job title and give a brief description of duties.
Reason for leaving:
Employer
Telephone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employed (month and year)
From MM slash DD slash YYYY
To MM slash DD slash YYYY
Name and Title of Supervisor/Reference
May we contact this employer?
Yes
No
State job title and give a brief description of duties.
Reason for leaving:
Employer
Telephone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employed (month and year)
From MM slash DD slash YYYY
To MM slash DD slash YYYY
Name and Title of Supervisor/Reference
May we contact this employer?
Yes
No
State job title and give a brief description of duties.
Reason for leaving:
Employer
Telephone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employed (month and year)
From MM slash DD slash YYYY
To MM slash DD slash YYYY
Name and Title of Supervisor/Reference
May we contact this employer?
Yes
No
State job title and give a brief description of duties.
Reason for leaving:
Employer
Telephone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employed (month and year)
From MM slash DD slash YYYY
To MM slash DD slash YYYY
Name and Title of Supervisor/Reference
May we contact this employer?
Yes
No
State job title and give a brief description of duties.
Reason for leaving:
Do you possess a valid Driver’s License?
Yes
No
Driver’s License No.
State
Class
Expiration Date
If a license, certificate, or other authorization to practice a trade or profession is required for the position for which you are applying, complete the following questions.
Name of trade or profession
Granted by
License level or number
Specialty
City and/or State of
Licensed from MM slash DD slash YYYY
to MM slash DD slash YYYY
How did you learn about us?
Advertisement
Friend/Relative
Walk-In
Website
Other
High School
Name and Location of School
From MM slash DD slash YYYY
TO MM slash DD slash YYYY
Major/Field
High School Graduate?
Yes
No
GED
Name and Location of School
From MM slash DD slash YYYY
TO MM slash DD slash YYYY
Major/Field
GED?
Yes
No
Business/Vocational
Name and Location of School
From MM slash DD slash YYYY
TO MM slash DD slash YYYY
Major/Field
List Type of Diploma, Degree or Certificate
College
Name and Location of School
From MM slash DD slash YYYY
TO MM slash DD slash YYYY
Major/Field
List Type of Diploma, Degree or Certificate
Other
Name and Location of School
From MM slash DD slash YYYY
TO MM slash DD slash YYYY
Major/Field
List Type of Diploma, Degree or Certificate
PLEASE READ CAREFULLYAPPLICANT’S CERTIFICATION AND AGREEMENT I hereby certify that the facts set forth in the above employment application are true and correct to the best of my knowledge. They are made voluntarily upon application of employment, and as inducement, therefore, I understand that any false statement orinformation given herein shall be considered sufficient cause for dismissal. I, the undersigned, do hereby authorize the City of Nixa to conduct an investigation with respect to my application and releasethe City, my former employers and personal references from any liability for damage caused by giving and receiving information oropinions as to my employment or character. Any examining doctors, hospitals (public, private, state and including the United StatesVeterans Administration), may give the City of Nixa any information or data as the result of any examinations made. I agree to hold the City harmless and in no event shall the City be liable to me for special, indirect, or consequential damages, forthe refusal of employment due to information obtained during my background security check. I understand and agree that the City of Nixa is under no obligation to reveal to me or any other person the reason for my rejection for employ-ment. I understand that I must physically reapply for employment if I wish to be considered for any other position open at the City of Nixa. I understand and agree with the City’s drug free workplace and that my employment with the City is contingent upon the drug test results.
"I acknowledge that I have read, understand, and agree to the APPLICANT’S CERTIFICATION AND AGREEMENT" (Required)
I Agree
Attach Resumé and/or other supporting documents to your application. Please attach a PDF copy of your resumé if you have one. You may also attach PDF copies of other relevant documents you wish to be included along with your application such as a cover letter, letters of referral, or transcript. Drop files here or Accepted file types: pdf, Max. file size: 100 MB, Max. files: 5.