Erie County Job Application

Application For Employment

Return to:

Human Resources
2900 Columbus Avenue
Sandusky, OH 44870
Phone: (419) 627-7678 Fax: (419) 627-7599

Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify the Human Resources Department. We consider all applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

Please note that Red asterisks denote a Required Field.

POSITION(S) APPLIED FOR: *

Date of Application: *

How did you learn about us?
Advertisement Relative Inquiry Web Site Employment Agency Friend Other Other:

First Name: *

Middle Name:

Last Name: *

Email Address: *

Street: *
Apt/Suite:
City: *
State: *
Zip Code: *

Telephone #: *

Cell/Other:

Have you ever submitted an application to Erie County? *

If yes, when?

Have you ever been employed by Erie County? *

If yes, when?

Are you legally eligible for employment in the United States? *

If you are under 18, can you furnish a work permit? *

Do you have a valid driver’s license? *

State / Number: *

Are you able to meet all of the attendance requirements of this position? *

Are you able to work overtime if necessary? *

Will you travel if the position requires it? *

Do you have any friends / relatives currently employed by Erie County? *

If Yes, who?

Military Service or Veteran Status? *

If yes, please provide branch of service, rank, and job duties:

What is your desired salary range or rate of pay: per

Date available for work:

Type of employment desired: Full Time Part Time Seasonal

EMPLOYMENT HISTORY Provide your work experience starting with your present or last job. Include any job-related military service assignments and volunteer activities. Exclude organizations that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran / reserve national guard or any other similarly protected status.

From: * To: *

Employer/Organization *

Telephone # *

Address *

Job Title: *

Supervisor: *

May We Contact? *

Job Duties / Responsibilities *
Reason for leaving *

From: To:

Employer/Organization

Telephone #

Address

Job Title:

Supervisor:

May We Contact?

Job Duties / Responsibilities
Reason for leaving

From: To:

Employer/Organization

Telephone #

Address

Job Title:

Supervisor:

May We Contact?

Job Duties / Responsibilities
Reason for leaving

PLEASE EXPLAIN ANY GAPS IN EMPLOYMENT:

Have you ever been fired or asked to resign from a job?
If yes, please explain:

EDUCATION:

	Name & Address of School	Course of Study	Years Completed	Diploma/Degree Obtained
High School	*	*	*	*
Undergraduate College
Graduate Professional
Other (Specify)

RELATED INFORMATION: To what job related organizations (professional, trade, etc.) do you belong? Exclude memberships that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran / reserve national guard or any other similarly protected status.

ORGANIZATION	OFFICES HELD

Please explain why you would like to be considered for employment with Erie County. Use additional sheets if needed.

REFERENCES: Please provide at least 3 professional references who are not related to you. Use additional sheets if necessary.
NAME:	RELATIONSHIP:
ADDRESS:	PHONE:
NAME:	RELATIONSHIP:
ADDRESS:	PHONE:
NAME:	RELATIONSHIP:
ADDRESS:	PHONE:

Have you been provided with a written job description for the position which you are applying? Yes No

Are you capable of performing the essential duties, responsibilities, and functions of the job for which you have applied? Yes No

APPLICANT STATEMENT AND SIGNATURE (Signature Required for Application to be Complete): I certify that all information I have provided in order to apply for and obtain employment with Erie County is true, complete, and correct. I agree and understand that omissions, misstatements, and falsifications will cause forfeiture on my part of all eligibility to any employment with Erie County and may be cause for rejection of this application, removal of my name from eligibility lists, or discharge from County service, whenever it is discovered. In addition, I give Erie County the right to investigate and verify any information obtained through the application process. Permission is granted and I release from any and all liability any employer, agency or individual assisting Erie County in providing relevant, job related information that will assist in this process. I expressly authorize, without reservation, Erie County, its representatives, members or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application. I hereby waive any and all rights and claims I may have regarding Erie County, its agents, members or representatives, for seeking, gathering, and using such information and all other persons, corporations, or organizations for furnishing such information about me. I understand that an offer of employment may be contingent upon the successful completion of a pre-employment background criminal investigation, physical, psychological, polygraph, and/or drug and alcohol screen. If employed, I agree to provide proof of identity, relevant licensure or credentials, and authorization for employment in the United States. If I am hired, I understand that, unless otherwise defined by applicable law, any employment relationship with Erie County is of an “at will” nature, which means that I am free to resign at any time and Erie County reserves the same right to terminate my employment at any time. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that all conditions of employment including, but not limited to hours, benefits and salary are subject to change by Erie County at any time. I understand that no representative of Erie County is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the appropriate Appointing Authority. I understand that a new application must be completed for any future job postings or employment opportunities with Erie County.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.
Date:

Erie County Board of Commissioners
Application Information

Only solicited applications will be accepted.
Please read the following information before completing our applications.

There is no guarantee of a job offer or job interview by completing our employment application. Your application will be considered with others who have submitted applications for the same job opportunity, and decisions about interviews will be based on this comparison.
Our application form must be completely filled out in order for it to be considered for employment.
If the information provided on our application cannot be satisfactorily verified by employment reference checks, your application could be considered incomplete.
We do not accept or maintain on file unsolicited applications. Applications are filed according to specific job opportunities.
Due to the large number of applications we receive and the competitive nature of our employment process, specific reasons for employment decisions will not be released.
By completing our employment application, you may be subject to the following checks:
1. Employment reference checks from previous employer and from current employer should a job offer be made.
2. Criminal record check.
3. Drug screen and/or pre-placement physical examination
4. Abstract driving record
5. Personal references
6. Educational degrees.

Applications may be returned in person to the Erie County Human Resources Office, by mail to the Erie County Department of Human Resources, 2900 Columbus Avenue, Sandusky, Ohio 44870 or by fax to (419) 627-7599. Applications are also accepted at Your Job Store, 221 W. Parish St., Sandusky (operating hours Monday through Friday, 8:00 a.m.-4:30 p.m.).

We welcome telephone inquiries from the public at (419) 627-7678 during normal working hours, Monday through Friday, 8:00 a.m. to 4:30 p.m. The Human Resources staff will verify current job postings, salary, the department for which the position is posted, and the date the position closes.

Thank you for your interest in employment with Erie County.

Erie County Department of Human Resources

2900 Columbus Avenue, Suite 210
Sandusky, OH 44870

Phone - 419-627-7678
Fax – 419-627-7599

This supplemental form must be completed and returned with your application. This will ensure your application is valid and will be considered for this employment opportunity.

(yes)	Did you answer all questions appropriately in legible handwriting (in ink) or typewritten? A resume may be included with the application if you wish but the application must be completed in its entirety. Responding with “see resume” is not acceptable.
(yes)	Are you related to anyone employed by Erie County? If your answer is yes, please fill out the following: Name: Relationship: Department:
(yes)	If applying for an RN or LPN position, please list your State of Ohio RN or LPN license number here:
(yes)	If required for the position for which you are applying, do you have a valid commercial driver’s license (CDL)? If your answer is yes, please fill out the following: CDL#: What class? Endorsements?
(yes)	Effective 7/1/94 by the Board of Erie County Commissioners, all applicants offered a position with the Board of Erie County Commissioners will have a physical medical examination including drug screen after the conditional offer of employment but before final acceptance as an employee of the board.
(yes)	Did you sign and date the application?
Authorization to Conduct Background Investigations I, hereby authorize the County of Erie, or its agents/employees, to conduct a background investigation or records check through its own or third party means. I hereby authorize release of information which may impact the decision on my future employment with Erie County. I understand that if an adverse employment decision is made based upon the information obtained through a third party investigation or records check, I am entitled to a copy of the report upon which the adverse employment decision was made. This authorization for release of information is applicable for one (1) year after the date of my initial application or re-application for a position with Erie County, Ohio. Social Security Number (required): I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement and give permission to conduct background checks. Date: Browse for your file and then click the 'Attach File' link. Your file(s) will be visible here before you Submit. Attach File

Once the application is complete, please press “Submit Application” below to electronically submit your application.
The submit button will send your information to Erie County via email.

The Erie County Job Application
must be filled out on a desktop computer.