Employment Application

Note: answering ‘yes’ to the questions below does not constitute an automatic bar to employment. factors such as age and time of the offense, seriousness and nature of the violation, and the rehabilitation will be taken into account.

I certify that answers given herein are true and complete to the best of my knowledge. I understand that any false or misleading information given by me on this application or throughout the selection process could cause me to be ineligible for or terminated from employment. To assist in determining my qualifications and fitness to perform the duties of this position or any position with the City of Bartlesville, I authorize the City of Bartlesville to investigate and verify information obtained through this application and the selection process. I hereby release the City of Bartlesville and its agents from all liability in making such investigations and inquiries. Furthermore, I release my employers, schools, or persons from all liability in responding to inquiries in connection with my application. If after reviewing my application form, verifying my responses, and conducting necessary interview or tests, I am considered for the job and would need reasonable accommodation to perform the essential job functions, the parties will explore these alternatives. Once conditional offer of employment is made, I understand that the City may conduct a medical exam to determine whether I can do the essential functions of the job without substantial risk to myself and the public. I further understand that I am required to abide by all rules and regulations of the City. I understand that this is not a contract for employment. The City of Bartlesville performs post-offer, pre-employment drug testing.

In connection with the City of Bartlesville’s consideration of me for employment, I understand that the City of Bartlesville and its agents may conduct investigative inquiries into my background that will include consumer, credit, criminal, driving, personal reference, job reference, DOT drug and alcohol testing history results, and other reports pertaining to me. These reports may include personal conversations with persons possessing knowledge relevant to these categories. These background inquiries will be conducted and reports obtained to provide the City of Bartlesville with information regarding my character, general reputation, personal characteristics, work record and characteristics, skills and abilities, education and training, employment experiences, past job performance, reasons for termination for previous employment and other pertinent information. If hired by the City of Bartlesville, I understand that I must comply with all policies and procedures of the City of Bartlesville.

I understand the above uses and purpose for which the City of Bartlesville may seek this information about me. I understand that I have a right to make a written request within a reasonable period of time to receive complete information about the nature and scope of the investigation. I hereby give my consent to the City of Bartlesville or anyone acting on its behalf obtaining the above stated information.

I authorize any person or entity contacted by the City of Bartlesville or anyone acting on its behalf to furnish the above-stated information, and I release any such person or entity from any and all liability for furnishing such information. I also release the City of Bartlesville from any and all liability for conducting such an investigation.