THE CITY OF WOODWARD

APPLICATION FOR CITY EMPLOYMENT

Position desired_______________________________________ Date of Application_________

Date available for work__________________________________________________________

Are you available to work ____full time ____part time ____shifts ____weekends ____nights

If part time, what hours and days___________________________________________________

Last Name__________________________First____________________Middle_____________

Street Address________________________________________ Home Phone_______________

City, State, Zip________________________________________ Work Phone_______________

Have you ever worked for this City?______Yes ______No If yes, give prior names, dates and
reasons for leaving______________________________________________________________

Are you legally eligible to work in the United States?______Yes _____No (Verification will be based
upon employment and failure to furnish documentation will be cause for separation.)

Do you hold a current and valid driver’s license? _____Yes _____No

If so, give state, expiration date and number: _________________________. If CDL, what class?_____
(If tentatively selected, applicants applying for position where driving is required, may be required to
furnish a copy, at their expense, of their driving record prior to employment.)

Are you related to any City employee or any member of the City Commission? ____ Yes ___No
If so, give name, department and relationship_________________________________________

Have you been charged with a crime or convicted of a felony in the last 7 years or are you currently
charged with the commission of a felony? ___Yes ___No If yes, state what, when and
how?_________________(Note: This information does not, in itself, disqualify you from employment.)

Give name, address and phone number of three references who are not related to you and are not previous
employers:

Name:___________________________Address:_____________________Phone:____________

Name:___________________________Address:_____________________Phone:____________

Name:___________________________Address:_____________________Phone:____________
Military Service Branch: ______________________________Date entered:________________
Date and Type of Discharge:______________________________________________________
Indicate specific military experience or training that is job related:________________________
_____________________________________________________________________________

After reviewing the essential job functions from the job description, are you able to perform
them? _____Yes _____No

The City is concerned with your ability to perform the job and will not, at this time, consider
your need for reasonable accommodation. If, after reviewing your application form, verifying
your responses, and conducting necessary interviews and tests, you are considered for the job
and would need reasonable accommodation to perform the essential job functions, the parties
will explore these alternatives. NOTE: The City may conduct a pre-employment exam which
will determine whether you can do the essential functions of the job without substantial risk to
yourself and the public.

In addition, review the minimum qualifications and provide us with prior education, work
experience, and any relevant training or certificates and licenses that would indicate your
knowledge, skills, and abilities to perform the job. Be as specific as possible since you will be
screened on what you include regardless of what you might otherwise be able to perform.

EDUCATIONAL RECORD

Name and Course of Check Last Did you List Diploma

School Address of Study Year graduate? of Degree
School Completed
5 6 7 8
Elementary

1 2 3 4
High School

1 2 3 4
College

Other educational background (please specify):________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

If you need additional space for the following information,

please continue on a separate sheet of paper.
 EMPLOYMENT EXPERIENCE
1. Employer, address, Date Started To Work Performed
phone number

Job Title: Hourly Hourly

Rate/Salary Rate/Salary
Starting Final

Supervisor:

Reason for leaving:

2. Employer, address, Date Started To Work Performed

phone number

Job Title: Hourly Hourly

Rate/Salary Rate/Salary
Starting Final

Supervisor:

Reason for leaving:

3. Employer, address, Date Started To Work Performed

phone number

Job Title: Hourly Hourly

Rate/Salary Rate/Salary
Starting Final

Supervisor:

Reason for leaving:

4. Employer, address, Date Started To Work Performed

phone number

Job Title: Hourly Hourly

Rate/Salary Rate/Salary
Starting Final

Supervisor:

Reason for leaving:

It is understood and agreed upon that any misrepresentation by me in this application will be
sufficient cause for cancellation of this application and/or separation from the employer’s service
if I have been employed.

As an applicant for a position with the City of Woodward, I have been asked to furnish
information for use in reviewing my background and qualifications. In this connection, I hereby
authorize the City of Woodward to investigate my past and present work, character, education,
military and police records to ascertain any and all information which may be pertinent to my
employment qualifications. I agree to cooperate in such investigation and release from all
liability or responsibility all persons and corporations requesting or supplying such information.

I understand that the City of Woodward has a mandatory drug screen program for job applicants
who are offered employment. If I am offered employment by a City department, I understand I
will be required to provide a urinalysis sample and/or blood test for drug screen purposes. The
screen will be to identify the presence of controlled or other prohibited substances. Failure of the
drug screen or refusal to submit to the screen will result in denial of employment.

I understand that I must possess and maintain a valid Oklahoma driver’s license during the
course of my employment, and I must meet the requirements of the City’s insurance carrier.

The City of Woodward is an Equal Opportunity Employer. The City of Woodward does not
discriminate in employment and no questions on this application are used for the purpose of
limiting or excusing any applicant’s consideration for employment on a basis prohibited by local,
state or federal law.

This application is current for only the job specified. If I have not heard from the City of
Woodward and still wish to be considered for employment for another job opening, it will be
necessary to fill out a new application.

I understand that, just as I am free to resign at any time, my employment and compensation is
terminable at-will. The City of Woodward may terminate my employment at any time and for
any reason whatsoever, with or without good cause and without prior notice. I understand that no
representatives of the City of Woodward have the authority to make any assurances to the
contrary.

I hereby acknowledge that I have read the above statements and understand the same.

APPLICANT:

Print Name:___________________________________________

Signature_____________________________________________ Date__________
Dear Applicant:

The City of Woodward wishes to thank you for your interest in employment with us. We would
like to take this opportunity to explain the hiring process of the City and provide some tips on
completing the application.

Hiring Process: All applications will be reviewed by the appropriate Department Head. If your
application is chosen for further consideration, you will be contacted by the Department Head or
a representative of the respective department to schedule an interview. After the interviewing
process, which may include more than one interview and testing to determine the skill level of
the applicant, the Department Head will make a selection. The applicant will then be advised to
report to the Payroll/Benefits Clerk to begin the hiring process. The hiring process is not
complete until the applicant successfully completes all the steps of the process and is approved
by the City Manager.

Notification: If you are not contacted within 14 days of the closing date of the opening, if one
has been set, you should assume your application was not selected for consideration at the time.
You may, however, inquire on the status of your application by contacting the City Manager’s
Office (580-254-8512) between the hours of 8:00 a.m. and 5:00 p.m., Monday through Friday.
The City Manager’s Office will direct you to the appropriate Department Head.

Quality of Applications: As your application provides the first, and perhaps only, impression of
you as a potential employee, you need to ensure that you do a good job in completing it. It is
important that you provide accurate and complete information that is easy to read. It is also
important to provide a reliable phone number where you can be reached or a responsible person
who can take a message for you. Applications must be turned in no later than 5:00 p.m. of the
closing date, if one has been set. Late applications will not be considered.

We thank you for your time and interest in becoming part of the City of Woodward workforce.
Current job listings are available at:

Our office: Located at 1219 Eighth Street, Woodward, OK 73801

Our website: www.cityofwoodward.com

The City of Woodward

City Manager’s Office
1219 Eighth Street
Woodward, OK 73801
EMAIL: [email protected]
Phone: 580-254-8512
Fax: 580-254-8514