Form Center

Applicant Background

Deerfield Address
Village of Deerfield
850 Waukegan Road
Deerfield, Illinois 60015
Date
Date
Equal Employment Opportunity Statement
It is the express policy of the Village of Deerfield to consider all applicants for employment without regard to race, color, religion, gender, age, physical disability, political affiliation, natural origin or any other legally protected status, in accord with applicable legal requirements.
Title of position for which applying:*
Can you perform the essential functions of the job for which you are applying?*
1. Yes
1. No
Upload PDF Resume*
Upload PDF Cover Letter
Upload Other PDF Document
First Name*
Middle Name
Last Name*
Any other names used:
Email Address*
Address*
City*
State*
Zip Code*
Phone Number*
Include area code.
How did you learn of this opening?
If hired, on what date would you be available to start work?
Previous employment with the Village of Deerfield?*
1. Yes
1. No
Department of previous employment:
Are you legally authorized to work full time in the United States?*
1. Yes
1. No
Do you posses a valid driver's license? *
1. Yes
1. No
Do you have experience operating specialized equipment?*
1. Yes
1. No
List equipment in which experienced:
What languages, other than English, do you speak and/or write fluently?
Have you ever been convicted or a crime, excluding minor traffic offenses?*
1. No
2. Yes
If convicted of a crime, please describe:
Continue

1. High School Name
Number of Years Attended
Graduated
1. Yes
2. No
Address
College Name
Number of Years Attended
Graduated
1. Yes
2. No
Address
Field of Study & Degree
Post Graduate School Name
Number of Years Attended
Graduated
1. Yes
2. No
Address
Field of Study & Degree
Trade or Other Educational Experience
Number of Years Attended
Graduated
1. Yes
2. No
Address
Field of Study & Degree
Use this space to continue any answers from other questions, to explain or list any special qualifications, certifications, or licenses pertinent to the position for which you are applying, or to provide any additional information necessary to describe your full qualifications.
Continue |Go Back

I understand nothing in this application creates an employment contract or relationship. I also understand that if hired by the Village of Deerfield, my employment may be terminated at any time, by myself or by the Village, for any grounds not prohibited by law. I certify that all information I have supplied on this form is correct to the best of my knowledge. I understand that omission or deliberate misinformation will disqualify my application and, if hired, would serve as grounds for dismissal. I consent to have the Village of Deerfield contact the people listed on this form for reference and authorize these individuals to provide truthful information regarding my qualifications for employment and previous work. I also agree to waive liability against persons named as references, provided the information they supply is honest, factual and given without malice. *
1. I understand, certify, consent, and agree.

Leave This Blank: