I. POSITION APPLYING FOR:
Name:
Last Name First Name M.I.
Current Address:
Street Address City State Zip Code
Phone Number: SSN: Salary Desired:

II. LIST OF PRIOR EMPLOYERS, MOST RECENT FIRST:

A.  Firm: Phone Number:
Dates of Employment:  From: To: Position Held:
If presently employed, leave To: field blank
Address:
Describe Duties:
Reason for Leaving:
Beginning Salary: Ending Salary:
Supervisor: May we contact?

B.  Firm: Phone Number:
Dates of Employment:  From: To: Position Held:
Address:
Describe Duties:
Reason for Leaving:
Beginning Salary: Ending Salary:
Supervisor: May we contact?

C.  Firm: Phone Number:
Dates of Employment:  From: To: Position Held:
Address:
Describe Duties:
Reason for Leaving:
Beginning Salary: Ending Salary:
Supervisor: May we contact?

III. EDUCATION:

INSTITUTION

ADDRESS

DATES OF ATTENDANCE

GRADUATE

  DEGREE
High School:

Junior College:

University/College:

Technical:

Other:


IV. BUSINESS/PROFESSIONAL REFERENCES:

NAME ADDRESS PHONE POSITION HELD
1.
2.
3.

V. GENERAL:

A. Can you perform the essential functions of the position for which you are applying?    
     If no, please describe:
B.  Person to contact in case of emergency
     Name:    Telephone:     Address: 
     Relationship to you: 
C. Have you ever been convicted of a felony within the past seven years?    
     If yes, provide felony and dates:
D. Are you prevented from lawfully becoming employed because of Visa or Immigration Status?    
E. Do you have a relative employed with Natrona County or one of its affiliated department boards?    
     If yes, whom and in what capacity:
F.  Summarize special skills and qualifications: 
      Keyboard speed:   WPM      Operate a PC?       Calculator?      Transcriber?
G:   If applicable for the position, driver's license number: 
      State of issuance:    Expiration date:    Class: 

Natrona County, Wyoming, and its affiliated departments and boards, does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in the employment or provisions of service.

I understand that by checking below, and accepting employment (either part-time, full-time or temporary), I am an Employee at Will, whose employment may be terminated at any time, with or without cause, unless specifically modified by a written contract of employment or statutory provision.

I certify that answers given herein are true and complete to the best of my knowledge; and I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of my employment, I understand that false or misleading information given in my application or interview(s) may result in disciplinary action that could lead to termination of my employment.

If applying for a Sheriff's Office position, you must be 21 years of age.

Enter your date of birth:    (NOT REQUIRED)

Please enter your e-mail address:     Confirm e-mail: 

  
Attach a resume with this application by clicking on the Browse button.
**Please ensure that the path to your document is valid.**
 
Attach a writing sample with this application by clicking on the Browse button.
Please be patient after clicking on the Submit button