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The City of Oldsmar is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, sex, religion, age, marital status , or disability.
In order to be consider for employment, you must complete and sign this application. Incomplete and/or unsigned applications will not be considered. All information on this application is subject to verification. Assistance in completing this application is available on request.
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First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Have you ever gone by any other name or used a nickname if any type? If yes, please list all such names
Have you been interviewed for a position with the City of Oldsmar within the last two years?*
1. Yes
1. No
If so, when and for what position
Have you ever been convicted of a violation of the law other than a minor traffic violation?*
1. Yes
1. No
If yes, explain
(Answering "yes" may not necessarily disqualify you from consideration for employment. A number of factors, such as the nature of the offense, your age at the time, the remoteness in time of the event, etc. will be considered)
Are you eligible to work in the United States?*
1. Yes
1. No
Are you related to anyone employed by the City of Oldsmar?*
1. Yes
1. No
If yes, please provide the name, position and nature of relationship
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Which position are you applying for?*
Type of employment desired
1. Full Time
1. Part Time
1. Internship
How did you hear about the position?
Can you perform the essential functions of the position for which you have applied with or without reasonable accommodation? Please review job description before answering this question.*
1. Yes
1. No
(All offers of employment are conditioned on verification of the applicant's ability to perform the essential functions of the position with or without reasonable accommodation.)
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I voluntarily authorize and grant full consent to the City or its agents to conduct a thorough investigation into my prior employment and any other area of my background, including criminal, regardless of adjudication. I do further consent to the release and disclosure to the City or it's agents from any persons, companies, corporations or government agency any information sought concerning my background and release from liability the City or its agents of actions taken in connection with this investigation, as well as any persons, companies, corporations or government agency disclosing such information. 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, regardless of when discovered.

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*

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