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CFPUA Job Application
This form has been modified since it was saved. Please review all fields before submitting.
Steps
1.
CFPUA Application for Employment
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2.
CFPUA Application for Employment
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This section is incomplete
3.
CFPUA Application for Employment - Page 2
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4.
CFPUA Application for Employment - Page 3
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CFPUA Application for Employment
Equal Opportunity Information
CFPUA policy prohibits discrimination based on race, sex, color, creed, national origin, age or disability. Sex, age, or absence of disability is a bona fide occupational qualification in a small number of CFPUA jobs. The information requested below is provided voluntarily and will in no way affect you as an applicant. Its sole use will be for Equal Opportunity recruitment tracking purposes.
At the time of submission, this page will be detached and kept separate from the application form. Please only complete the following fields and do not write anything else on this page.
Date of Birth
Date of Birth
Gender
*
Male
Female
Prefer Not to Answer
Ethnic Group
*
White (Non-Hispanic)
Black or African American (Non-Hispanic)
Hispanic or Latino (Mexican, Puerto Rican, Cuban, Central or South American, other Spanish origin regardless of race)
Asian
Native Hawaiian or Other Pacific Islander
American Indian (including Alaskan Native)
Two or more races
Prefer Not to Answer
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CFPUA Application for Employment
Personal Information
Last 4 digits of SSN
*
Last Name
*
First Name
*
Middle Name
Street Address
*
City
*
State and Zip Code
*
Phone Number
*
Email Address
*
Position Applying For
Position Title
*
Vacancy Number
*
How did you hear about this opportunity?
Are you current CFPUA employee?
*
Yes
No
Have you ever been employed by CFPUA?
Yes
No
CFPUA former position titles and dates
Are you related to anyone currently working at CFPUA?
*
Yes
No
If yes, list name, relationship and department
Are you legally authorized to work in the United States?
*
Yes
No
Select the type of work you will accept:
*
Regular - Full Time
Regular - Part Time
Any
Enter the earliest date you could begin work:
*
Military Service
Have you served in the Armed Forces of the United States?
*
Yes
No
Dates Served
Branch
Rank/Grade
Type of Separation:
Honorable Discharge
Other than Honorable
Dishonorable
Education
High School Name/Location
*
Dates Attended:
*
Graduated:
*
Yes
No
College Name/Location
*
Dates Attended:
*
Graduated:
*
Yes
No
Degree and Major/Minor
*
IF YOU DID NOT ATTEND COLLEGE, TYPE "N/A" IN ALL BOXES
Graduate Name/Location
Dates Attended:
Graduate:
Yes
No
Degree and Major/Minor
Licenses/Certifications
Driver's License Number
*
State Issued
*
CDL
*
Yes
No
List any Professional Licenses and/or Certifications that are relevant to the position you are applying for:
Have you ever been convicted of an offense against the law other than a minor traffic violation?
*
Yes
No
If YES, please explain. The offense and timing of the conviction will be evaluated and does not automatically disqualify you for employment.
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CFPUA Application for Employment - Page 2
Employment History
Current or Last Employer:
*
Address:
*
Position Title:
*
Supervisor's Name:
*
Phone Number
*
Date - From:
*
To:
*
Type
*
Full Time
Part Time
Number supervised by you:
Starting Salary:
Ending/Current Salary
Reason for Leaving:
May we contact?
*
Yes
No
List major duties which demonstrate your competencies related to the position for which you are applying for:
*
Previous Employer #1:
Address:
Position Title:
Supervisor's Name:
Phone Number
Date - From:
To:
Type:
Full Time
Part Time
Number supervised by you:
Starting Salary:
Ending Salary:
Reason for Leaving:
May we contact?
Yes
No
List major duties which demonstrate your competencies related to the position for which you are applying for:
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CFPUA Application for Employment - Page 3
Previous Employer #2:
Address
Position Title:
Supervisor's Name:
Phone Number:
Date - From:
To:
Type:
Full Time
Part Time
Number supervised by you:
Starting Salary:
Ending Salary:
Reason for Leaving:
May we contact?
Yes
No
List major duties which demonstrate your competencies related to the position for which you are applying for:
Previous Employer #3:
Address:
Position Title:
Supervisor's Name:
Phone Number:
Date - From:
To:
Type:
Full Time
Part Time
Number supervised by you:
Starting Salary:
Ending Salary:
Reason for Leaving:
May we contact?
Yes
No
List major duties which demonstrate your competencies related to the position for which you are applying for:
Upload Resume
Upload Cover Letter
Upload Required Certificattions
Upload Miscellaneous Information
I certify that I have given true, accurate and complete information on this form to the best of my knowledge, If confirmation is needed about my information, I authorize educational institutions, associations, registrations and licensing boards, and others to furnish the details concerning my qualifications. I authorize the investigation of all statements made in the application and understand that false information or documentation, or a failure to disclose relevant information may be grounds for the rejections of my application, disciplinary action, or dismissal if I am employed, and/or criminal action. I further understand that dismissal upon employment shall be mandatory if fraudulent disclosures are given to meet the position qualifications.
Signature of Applicant
*
Date:
*
Date:
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
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