Online 911 Form LaSalle County Sheriff E911 Telecommunications Employment ApplicationQualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, or the presence of a non-job related medical condition or handicap.If you applied within the last 6 months, your application is still on file Applicant InformationDate* Date Format: MM slash DD slash YYYY Name* First Middle Last Date of birth* Date Format: DD slash MM slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Date Available* Date Format: MM slash DD slash YYYY Position Applied for*Are you a Citizen of the United States?* Yes No If no, are you authorized to work in the U.S.?* Yes No Have you filed an application here before?* Yes No If yes, when?* Date Format: MM slash DD slash YYYY Have you ever been employed here before?* Yes No If yes, when?* Date Format: MM slash DD slash YYYY Have you ever been convicted of a misdemeanor or felony?* Yes No If yes, explain*EducationHigh School* High School Name Address From* Date Format: MM slash DD slash YYYY To* Date Format: MM slash DD slash YYYY Did you graduate?* Yes No College College Name Address From Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY Did you graduate? Yes No DegreeOther Education (trade, technical, etc) School Name Address From Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY Did you graduate? Yes No DegreeList professional, trade, business, or civic activities and offices held (exclude groups which indicate race, color, religion, sex, or national origin)Can you travel if job requires it?* Yes No Are you available to work* Full Time Part Time Shift Work Any restriction on specific day(s) of the week?* Yes No If yes, please explainAre you able to sit for extended periods of time?* Yes No Do you have basic computer skills?* Yes No Previous EmploymentCompany NamePhoneAddress Street Address City State / Province / Region ZIP / Postal Code Job TitleStarting SalaryEnding SalaryResponsibilitiesFrom Date Format: MM slash DD slash YYYY To Date Format: YYYY dash MM dash DD Reason for LeavingCompany NamePhoneAddress Street Address City State / Province / Region ZIP / Postal Code Job TitleStarting SalaryEnding SalaryResponsibilitiesFrom Date Format: MM slash DD slash YYYY To Date Format: YYYY dash MM dash DD Reason for LeavingCompany NamePhoneAddress Street Address City State / Province / Region ZIP / Postal Code Job TitleStarting SalaryEnding SalaryResponsibilitiesFrom Date Format: MM slash DD slash YYYY To Date Format: YYYY dash MM dash DD Reason for LeavingMilitary ServiceBranchFrom Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY Rank at DischargeType of DischargeIf other than honorable, explainReferencesPlease list three professional referencesName* First Last Relationship*Company*Phone*Address* Street Address City State / Province / Region ZIP / Postal Code Name* First Last Relationship*Company*Phone*Address* Street Address City State / Province / Region ZIP / Postal Code Name* First Last Relationship*Company*Phone*Address* Street Address City State / Province / Region ZIP / Postal Code Disclaimer and Signature* SignatureI certify that my answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I will, if required, submit to a polygraph test. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all policy/procedure rules and regulations of my employer.Email
