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Employee Status: Normal
Office Status: Normal
Employee Information
 
    Human Resources
  
Fair: 59F


 


St. Mary's County Government is an equal opportunity employer and does not discriminate against any employee or applicant for employment

due to race, color, gender, age, marital status, sexual orientation, pregnancy, national origin, religion or belief, political affiliation or opinion, disability or any other legally protected or non-merit factor.

4. Position you are applying for:  (Submit a separate application for each position.) Full-Time Part-Time Hourly

 8. Have you been convicted or plead no contest to any criminal offense within the last ten years?

 

If yes, please explain:
( Characters Left)

 10. List all machines or equipment, including office equipment, you can operate skillfully. ( Characters Left)

      HIGH SCHOOL/GED

      School and Location: Course of Study (List Major)

      Did you Graduate? (Yes or No) Degree of Certificate (AA,BA, BS, MA, PhD)

     TECHNICAL/VOCATIONAL

      School and Location:   Course of Study (List Major)

       Did you Graduate? (Yes or No) Degree of Certificate (AA,BA, BS, MA, PhD)

     UNDERGRADUATE

      School and Location:    Course of Study (List Major)

      Did you Graduate? Yes or No) Degree of Certificate (AA,BA, BS, MA, PhD)

     GRADUATE

     School and Location:   Course of Study (List Major)

     Did you Graduate? Yes or No) Degree of Certificate (AA,BA, BS, MA, PhD)

      Do not repeat supervisors listed under Experience Item  15.

 15. Work History: Complete the following sections even if you are submitting a resume in addition to this application. 

Begin with your most recent employment and include at least 10 years of work history.

  Attach additional  sheets as necessary. Be concise, but do not omit information which may be relevant to the position for which you are applying.

     A. Dates of Employment

      From: To: Job Title: Number of Persons supervised:

      Salary: Hrs. Per Week: Name & Title of Supervisor:

      Area Code and Phone: Name and Address of Business or Employer:

      Reason you are considering a job change:

     May we contact your employer? If not, why not?

     Description of duties (DO NOT WRITE "SEE RESUME") ( Characters Left)

     

   B. Dates of Employment

      From: To: Job Title: Number of Persons supervised:

      Salary: Hrs. Per Week: Name & Title of Supervisor:

      Area Code and Phone: Name and Address of Business or Employer:

      Reason you are considering a job change:

     May we contact your employer? If not, why not?

     Description of duties (DO NOT WRITE "SEE RESUME") ( Characters Left)

     

   C. Dates of Employment

      From: To: Job Title: Number of Persons supervised:

      Salary: Hrs. Per Week: Name & Title of Supervisor:

      Area Code and Phone: Name and Address of Business or Employer:

      Reason you are considering a job change:

     May we contact your employer? If not, why not?

     Description of duties (DO NOT WRITE "SEE RESUME") ( Characters Left)

     

   D. Dates of Employment

      From: To: Job Title: Number of Persons supervised:

      Salary: Hrs. Per Week: Name & Title of Supervisor:

      Area Code and Phone: Name and Address of Business or Employer:

      Reason you are considering a job change:

     May we contact your employer? If not, why not?

     Description of duties (DO NOT WRITE "SEE RESUME") ( Characters Left)

     

   E. Dates of Employment

      From: To: Job Title: Number of Persons supervised:

      Salary: Hrs. Per Week: Name & Title of Supervisor:

      Area Code and Phone: Name and Address of Business or Employer:

      Reason you are considering a job change:

     May we contact your employer? If not, why not?

     Description of duties (DO NOT WRITE "SEE RESUME") ( Characters Left)

     

 16. Are you related by blood or marriage to any County Government employee(s) or any member of the Board of County Commissioners?

      Yes  No  If yes, complete the following:

      Name:   Department: Relation:

      Name:   Department: Relation:

      Name:   Department: Relation:

   17. Have you ever been employed with St. Mary's County Government? Yes  No  If yes, answer questions below:

      A. Dates of Employment

      From: To: Position Held:

      Reason for Leaving: ( Characters Left)

     

   18. Are you legally authorized to accept work and remain in the United States?

    (Proof of identity and authorization will be required upon employment)   Yes  No

   19. Are you currently 18 years or older? Yes  No  If not, state your age:

   20. Military Service

      A. Have you ever served on active duty in the United States Military? Yes  No 

      (Exclude tours of active duty for training as a reservist or National Guard)

      B. If Yes, list Dates, Branch and Serial or Service Number of All Active Service.

      From: To: Branch of Service:   Serial or Service No.

      C. Have you ever been discharged from the armed services under other than honorable conditions? Yes  No

          (You may omit any such discharge changed to honorable by a Discharge Review Board or similar authority.)

      If Yes, give details: ( Characters Left)

           

   21. Additional Information. ( Characters Left)

    

 

  

a.





This is an application for employment which includes an overview of our hiring process. You are officially employed by the Board of County Commissioners only after a Personnel Action has been issued by the Department of Human Resources. Any representation as regards to your appointment, setting of wages, or any other personnel action made to you by other than the Department of Human Resources is without authority and you are advised that you have no right to rely upon such representation. Concerns about our EEO policy or hiring process should be directed to the Director of Human Resources at 301-475-4200, extension 1100.

b.







In submitting this application for employment, I authorize investigation of all statements contained therein. I hereby authorize St. Mary’s County Government to make any contacts considered necessary to my employment, such as previous employers, criminal or credit bureau records. I authorize any person or organization whose name I have given as a character reference or by whom I have been previously employed and any educational institution which I have stated I attended to furnish the County any information they may have concerning me. I hereby release all such persons, organizations, and institutions from any claims for damages or otherwise by reason of furnishing such information and records. It is understood and agreed that any misrepresentations or omissions by me in this application will be sufficient cause for rejection of the application and/or for separation from County employment.

c.




I understand that as a condition of employment, I may be required to undergo and successfully pass a screening for substance abuse. I also understand and agree that, if employed, I may be required to submit to an alcohol or substance abuse screening as required by Law and St. Mary’s County Government’s Policies and Procedures. I hereby consent to having the results of any such alcohol or substance abuse screening I may be required to undergo disclosed to the hiring official.

d.



I understand that this application is the property of St. Mary’s County Government and will become part of my personnel file if I am accepted for employment. Driving record checks may be required on an applicant or employee who may be required to operate a County or personal vehicle on County business. This will also depend on the nature of the position and the insurance company’s requirements. I hereby authorize the County to obtain a complete driving history.

        Acknowledged and understood:

        Signature:   Date:

 

UNDER MARYLAND LAW AN EMPLOYER MAY NOT REQUIRE OR DEMAND ANY APPLICANT FOR EMPLOYMENT OR PROSPECTIVE EMPLOYMENT OR ANY EMPLOYEE TO SUBMIT TO OR TAKE A POLYGRAPH, LIE DETECTOR OR SIMILAR TEST OR EXAMINATION AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT, EXCEPT LAW ENFORCEMENT OFFICERS AS DEFINED IN 727 OF ARTICLE 27, OR ANY EMPLOYEE OF ANY LAW ENFORCEMENT AGENCY OF THE STATE OF MARYLAND, OR ANY COUNTY INCORPORATED CITY OR TOWN, OR OTHER MUNICIPAL CORPORATION. ANY EMPLOYER WHO VIOLATES THIS PROVISION IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT TO EXCEED $100.
     

      Acknowledged and understood:

       Signature:   Date:

       

EMPLOYMENT RECRUITMENT TRACKING INFORMATION

PLEASE COMPLETE THE FOLLOWING INFORMATION

VOLUNTARY INFORMATION

PLEASE CHECK ONE OF THE FOLLOWING

Persons having origins in any of the peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands and Samoa.
Persons having origins in any of the black ethnic groups.
Persons having origins in any of the Mexican, Puerto Rican, Cuban, Central or South American or other Spanish cultures, regardless of ethnicity.
Persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.
Persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.

 *checking the yes box has no effect on an employers obligation to provide reasonable accommodation under state and federal disability laws.

Resume:

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AN EQUAL OPPORTUNITY EMPLOYER