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City of Inkster - An Equal Opportunity Employer
City of Inkster
26215 Trowbridge Road
Inkster, MI 48141
Application for Examination and/or Appointment to the Position of:
First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Emergency Contact*
Relationship*
Phone Number
Address
City
State
Zip Code
Upload Your Resume
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General Information

Have you filed an application with the city before?
1. Yes
2. No
Date
Date
Have you ever been employed with the city before?
1. Yes
2. No
Are you a citizen of the United States?*
1. Yes
1. No
If not, do you possess an Alien Registration Card?
1. Yes
2. No
If yes, give Alien Registration Number
Are you available to work:
1. Full Time
2. Part Time
3. Temporary
4. Summer
Are you on lay-off and subject to recall?
1. Yes
2. No
Are you licensed in the State of Michigan to operate a motor vehicle?
1. Yes
1. No
Do you have relatives who work with the city?
1. Yes
2. No
If yes, list name(s)
Are there any felony charges currently pending against you?*
1. Yes
2. No
Have you ever pled “guilty” or “no contest” or been convicted of a crime?*
1. Yes
2. No
If yes, explain when, where, and nature of offense.
Important Note
Answer “Yes” to these questions does not constitute an automatic ban to employment. Factors such as date of offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered.
Have you ever been discharged, asked to resign or resigned in lieu of discipline or discharge?
1. Yes
2. No
Are you a veteran of the U.S. Military Service?
1. Yes
2. No
If yes, what was your Branch of Military Service?
For reference checks and work history purposes, have you worked for a company under a different name? If so, indicate:
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Position Information

Which position are you applying for?*
Type of employment desired*
1. Full Time
1. Part Time
1. Internship
Saraly desired*
Hours of work (per week) desired*
Have you read the position description?
1. Yes
2. No
Can you perform the essential functions of the position applied for with or without reasonable accommodation?
1. Yes
2. No
Explain:
How did you hear about the position?*
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Education

High School
Address
Do you have a GED Certifiate?
1. Yes
2. No
Did you graduate?
1. Yes
2. No
Colleges, Trade or Technical Schools Attended
College
Address
Number of Years Completed
Major / Minor
Type of Degree
Graduate?
Trade / Technical School
Address
Number of Years Completed
Type of Degree
Major / Minor
Graduate?
Other School
Address
Number of Years Completed
Type of Degree
Major / Minor
Graduate?
Education & Skill Explanation, if applicable
Typing WPM
Shorthand WPM
Other
Are you now, or have you ever been certified or a licensed member of any trade or profession (such as electrician, mechanic, radio operator, etc.)?
1. Yes
2. No
If so, indicate kind of certification or license, state, and period covered:
Additional Work or Volunteer Experience, Training, Self-Study
Please describe any information which you feel would be useful as an aid in determining your suitability for the position for which application is being made. You may wish to include volunteer or other uncompensated work experience, informal training, self study, hobbies, or work experience not shown elsewhere on this application.
A civil service test may be required for classified positions.
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Employment History

From Most Recent Job
Please indicate every employment (including periods of military service) and every period of unemployment since you first began to work. Start with your most recent job and work backwards to the first job you ever held.

For periods of unemployment use extra space allowed on this application.
Company
Position
Supervisor
Phone Number
Number of Employees You Supervised
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Part time or full time?
Final Salary
Reason for Leaving
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Number of Employees You Supervised
Address
Responsibilities
Employed From - To (Date)
Part time or full time?
Salary
Reason for Leaving
Company
Position
Supervisor
Phone Number
Number of Employees You Supervised
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Part time or full time?
Salary
Reason for Leaving
Periods of Unemployment
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References

Please list three professional references.
Full Name*
Relationship*
Company*
Phone Number*
Full Name*
Relationship*
Company*
Phone Number*
Full Name*
Relationship*
Company*
Phone Number*
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Disclaimer & Signature

I certify the facts set forth in this Application of Employment, in my resume, and in any other materials I have submitted are true and complete. I understand that the submission of any false information in connection with my application for employment will result in immediate discharge at any time thereafter, should I be employed by the City of Inkster (hereinafter “the City”).

I hereby authorize the City to contact all my former and current employers, educational institutions, military entities, and the other references I have provided regarding me and my performance record and work, academic and/or military experience I also hereby release the City and its employees, Council Members, officers, and agents, and all of my former and current employers, educational institutions, military entities, and the other references I have provided, from any and all liability and damages for releasing or using information concerning me and my performance record and work, academic and/or military experience. I also hereby waive any right under the Bullard-Plawecki Right to Know Act, 1978 PA 397, to receive written notice from the City or any former or current employer, that disciplinary reports, letters or reprimand, or other disciplinary actions taken against me while employed, will be or have been disclosed to a third person or entity.

I also understand that the City may, in its sole discretion, conduct or have conducted by an individual or entity of its choice, a conviction-only criminal background history search on me. I hereby consent to this search being conducted and to the disclosure of the result of that search by the individual or entity conducting the search to the City. I further hereby release the individual or entity conducting the search, the City, and its employees, Council Members, officers, and agents, from any and all liability, claims and damages, including but not limited to, claims for releasing or using any information revealed as a result of this search. I also understand and acknowledge that false information provided by me or criminal convictions will result in disqualification from employment with the City or in dismissal from employment if an offer of employment has been made and accepted.

Subsequent to an offer of employment being made, I agree to undergo the necessary medical examination conducted by a physician or other professional of the City’s choice and understand that such offer of employment is conditioned upon the results of this examination.

If I am employed, I understand that additional personal data may be required for determination of benefit eligibility and for statistical purposes.

I will abide by all policies, rules and regulations of the City.
Electronic Signature Agreement
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
Applicant Signature*
Date
Date
Please note
Only completed applications will be considered.
Date Application Filed
Date Application Filed
Date Application Filed
Date of Examination
Date of Examination
Notice of Examination
Name of Examination
Score
Notification of Standing
Comments
Personnel Department Official Electronic Signature
Date
Date

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