CLARK COUNTY APPLICATION FOR EMPLOYMENT PART-TIME

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CLARK COUNTY APPLICATION FOR EMPLOYMENT PART-TIME CLARK COUNTY HUMAN RESOURCES 500 S. GRAND CENTRAL PKWY 3 RD FLOOR PO BOX 551791 LAS VEGAS NV 89155-1791 PHONE: (702) 455-4565 FAX: (702) 455-2253 www.clarkcountynv.gov INSTRUCTIONS FOR COMPLETING THIS PART-TIME APPLICATION Any modification or re-creation of Human Resources official application will result in the application being rejected. 1. You must turn in a separate application for each job you want to apply for. 2. Print (black or blue ink), or type your information onto the application. If those reviewing your application can not read your writing you may not get credit for your experience. 3. Describe each job you list in detail and completely. Those reading your application may not understand what you have done in other jobs unless you explain exactly what your duties were. 4. Your application and any other paperwork you need to submit, certificates, etc., must be received by 5:00 p.m. on the closing date listed at the top of the job announcement. 5. Human Resources does not provide copies of applications or any other documents you submit. You need to make copies before you turn in your application package.

500 SOUTH GRAND CENTRAL PARKWAY, PO BOX 551791, LAS VEGAS, NV 89155-1791 (702) 455-4565 NOTE: ANY MODIFICATION OR RE-CREATION OF HR S OFFICIAL APPLICATION OR SUPPLEMENTAL WILL RESULT IN THE APPLICATION BEING REJECTED. PERSONAL PROFILE NAME: LAST FIRST MI OTHER NAMES USED: EMAIL CITY: STATE: ZIP CODE: HOME PHONE: ALTERNATE PHONE: AFTER OFFER OF EMPLOYMENT, CAN YOU, SUBMIT PROOF YES NO OF YOUR LEGAL RIGHT TO WORK IN THE UNITED STATES? DRIVER S LICENSE: STATE: CLASS: ENDORSEMENT: ARE YOU AN HONORABLY DISCHARGED VETERAN? YES NO (IF YES, YOU MUST SUBMIT A COPY OF YOUR DD-214 MEMBER-4 FORM WITH THIS APPLICATION STATING YOUR DISCHARGE WAS HONORABLE ) MARK ALL OF THE WORKING CONDITIONS YOU WILL ACCEPT: PERMANENT TEMPORARY WEEKENDS PART-TIME NIGHTS ARE YOU CURRENTLY EMPLOYED BY THE COUNTY? YES NO (IF YES, COMPLETE THE FOLLOWING) TITLE: DEPARTMENT: DIVISION: STATUS: PERMANENT PART-TIME TEMPORARY DO YOU HAVE ANY RELATIVES WORKING FOR CLARK COUNTY? YES NO IF YES, COMPLETE THE FOLLOWING: NAME: DEPARTMENT: RELATIONSHIP: EDUCATION YOUR HIGHEST LEVEL OF EDUCATION: Some High School Some College Bachelor s Degree Certificate of Attendance Technical College Master's Degree High School (name/city/state): High School, GED Associate's Degree Doctorate GED: Certificate of Attendance: Junior College (name/city/state): # Credits Completed: Major: College/University (name/city/state): # Credits Completed: Major/Minor: College/University (name/city/state): # Credits Completed: Major/Minor: Trade/Vocational (name/city/state): Certificate Received: Date Received: Area of Study:

EXPERIENCE: STARTING WITH YOUR MOST RECENT JOB, INCLUDE ALL EMPLOYMENT. LIST ALL YOUR WORK/VOLUNTEER EXPERIENCE THAT QUALIFIES YOU FOR THE JOB YOU ARE APPLYING FOR. HUMAN RESOURCES WILL DETERMINE WHETHER OR NOT YOU MEET THE MINIMUM QUALIFICATIONS FOR THE JOB BASED ON YOUR EXPERIENCE AS YOU DESCRIBE IT ON YOUR APPLICATION. DO NOT SUBSTITUTE A RESUME, OR WRITE SEE ATTACHED RESUME FOR THIS APPLICATION, AS INFORMATION ON YOUR RESUME WILL NOT BE CONSIDERED. NOTE: ANY MODIFICATION OR RE-CREATION OF HR S OFFICIAL APPLICATION OR SUPPLEMENTAL WILL RESULT IN THE APPLICATION BEING REJECTED. EMPLOYMENT HISTORY MAY WE CONTACT YOUR PRESENT EMPLOYER? YES NO 1. COMPANY/AGENCY NAME: 2. COMPANY/AGENCY NAME:

NOTE: ANY MODIFICATION OR RE-CREATION OF HR S OFFICIAL APPLICATION OR SUPPLEMENTAL WILL RESULT IN THE APPLICATION BEING REJECTED. EMPLOYMENT HISTORY (CONTINUED) 3. COMPANY/AGENCY NAME: 4. COMPANY/AGENCY NAME:

NOTE: ANY MODIFICATION OR RE-CREATION OF HR S OFFICIAL APPLICATION OR SUPPLEMENTAL WILL RESULT IN THE APPLICATION BEING REJECTED. List all criminal convictions that you have on your record, that are higher than a moving violation. Please include the state, date, and disposition of each conviction. Clark County, NV does not accept a resume in lieu of a completed employment application. Qualifying education and experience, including Clark County employment must be clearly documented in the Education and Work Experience sections of the application. Do not substitute a resume for your application or write "see attached resume" on your application. I understand my resume will not be accepted in lieu of a completed employment application. Applicants must provide their work history, including Clark County employment, and job duties in their own words. Clark County, NV does not accept language copied word-for-word from a job description as qualifying job experience on an application. I understand my application must be completed in my own words. The entire application must be completed to be considered. Incomplete applications or applications that are missing required documents will not be considered. I understand that I must submit a completed application to be considered. I further understand that an incomplete application or applications that are missing required documents will not be considered. I am aware that in an effort to go Green, Clark County will only be sending electronic notices I understand that Clark County Human Resources will only be sending electronic notices. Clark County Human Resources will only accept degrees or credits earned from a college or university accredited by an official agency recognized by the US Department of Education. A listing of accredited universities is available at: http://ope.ed.gov/accreditation. I understand the education accreditation requirement. Have you ever been employed at Clark County? Dates of employment with Clark County. What was your employment status? Full-time Part-time Temporary

BY SUBMITTING THIS APPLICATION, I VERIFY ALL STATEMENTS MADE ARE TRUE AND COMPLETE TO THE BEST OFMY KNOWLEDGE. I UNDERSTAND THAT: 1) ANY FALSE STATEMENTS OR INCOMPLETE INFORMATION WILL BE CAUSE FOR REJECTION OF MY APPLICATION MATERIALS OR DISCHARGE FROM EMPLOYMENT. 2) I UNDERSTAND THAT PRIOR TO EMPLOYMENT, I MUST SHOW PROOF OF CITIZENSHIP OR LEGAL RIGHT TO WORK IN THE UNITED STATES. I UNDERSTAND AS INDICATED ON THE ONLINE EMPLOYMENT APPLICATION I MUST LIST ALL CRIMINAL CONVICTIONS THAT I HAVE ON MY RECORD, THAT ARE HIGHER THAN A MOVING VIOLATION. I MUST INCLUDE STATE, DATE, AND DISPOSITION OF EACH CONVICTION. I FURTHER UNDERSTAND THAT A CONVICTION DOES NOT AUTOMATICALLY BAR ME FROM EMPLOLYMENT. I UNDERSTAND THAT EMPLOYMENT IS CONTINGENT UPON SUCCESSFUL COMPLETION OF A BACKGROUND INVESTIGATION. PERIODICALLY AFTER EMPLOYMENT BACKGROUND INVESTIGATIONS MAY BE CONDUCTED. SUBMITTING THIS APPLICATION AUTHORIZES CLARK COUNTY TO CONDUCT ANY AND ALL NECESSARY BACKGROUND CHECKS RELATED TO THIS POSITION. SIGNED: DATE: PRINT NAME: