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Job Application

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Steps

1. Personal Information This section is complete This section is incomplete
2. Position Information This section is complete This section is incomplete
3. Education & Training This section is complete This section is incomplete
4. Language & Computer Skills This section is complete This section is incomplete
5. Employment History This section is complete This section is incomplete
6. References This section is complete This section is incomplete
7. Disclaimer & Signature This section is complete This section is incomplete

Personal Information

First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Are you eligible to work in the United States?*
1. Yes
1. No
Have you ever been employed by Templeton CSD?
1. Yes
1. No
If yes, in what department?
Do you possess a valid California Driver's License?
1. Class A (Commercial)
1. Class B (Commercial)
1. Class C
1. No Driver's License
Have you ever been a member of the State or Public Employees Retirement System (PERS)?
1. Yes
1. No
If yes, please list Agency and Dates of Employment
Upload Your Resume
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Position Information

Which position are you applying for?*
Type of employment desired*
1. Full Time
1. Part Time
1. Internship
What type of employment will you accept? (check all that apply)
1. Full Time
2. Permanent Part-Time Work (less than 40 hours)
3. Temporary, Extra-Hire (as needed)
4. Evening/Night Work
5. Saturday/Sunday Work
Hours of work (per week) desired*
How did you hear about the position?*
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Education & Training

High School
Address
College
Address
Degree
Other Professional Certifications
Date Earned
Expiration Date
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Language & Computer Skills

In addition to English, are you fluent in any other language? (list all that apply)
Please rate your computer skills on the following:
Microsoft Word
1. Beginner
2. Intermediate
3. Advanced
Microsoft Excel
1. Beginner
2. Intermediate
3. Advanced
Microsoft Power Point
1. Beginner
2. Intermediate
3. Advanced
Microsoft Publisher
1. Beginner
2. Intermediate
3. Advanced
Microsoft Access
1. Beginner
2. Intermediate
3. Advanced
Microsoft Info Path
1. Beginner
2. Intermediate
3. Advanced
Microsoft Outlook
1. Beginner
2. Intermediate
3. Advanced
Adobe Acrobat Pro
1. Beginner
2. Intermediate
3. Advanced
Continue |Go Back

Employment History

(From Most Recent)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
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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*
Continue |Go Back

Disclaimer & Signature

I certify that my answers are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that if hired I may be released from employment.

I understand that the company may require me to successfully complete a pre-employment drug and alcohol test and a background check as a condition of employment and that continued employment may be based on the successful completion of similar tests.

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*

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Templeton Community
Services District
420 Crocker Street
Templeton, CA 93465
Phone: 805-434-4900
Fax: 805-434-4820

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