NOTE: If offered employment you will be required to provide documentation to verify employment eligibility. Failure to provide the requested documentation may result in a determination that the applicant is ineligible for employment in the United States.
Have you (since the age of 18) ever been convicted of or plead guilty or no contest to a misdemeanor? (For example: DUI, Bad Checks, etc)
(Omit non-moving traffic violations/parking tickets and any offense which was finally adjudicated in a Juvenile Court or under a Youth Offender Law)
Have you (since the age of 18) ever been convicted of or plead guilty or no contest to a felony?
NOTE: Applicants convicted of a criminal offense involving the manufacture, distribution,
trafficking, or sale of a controlled substance, dangerous drugs or marijuana, or convicted of any
felony involving a violent crime such as assault with a deadly weapon, aggravated assault or murder
are ineligible to be employed with the City of Sandersville. Such applicants will automatically be
rejected. Applicants convicted of any other felony shall be considered on a case by case basis. An
applicant convicted of a felony or misdemeanor who has received a pardon from the appropriate
State Pardons and Parole Board shall be eligible for employment with the City of Sandersville.
Please complete the following for post-secondary education (Technical Schools/Colleges/Universities):
Describe specialized training, qualifications, apprenticeship, skills and extra-curricular activities
which relate to the position for which you are applying. Include office equipment, computer skills,
foreign language skills, typing skills, and business equipment or machine operating skills which
may relate to the position for which you are applying.
Give names, addresses, and telephone numbers of three (3) references that ARE NOT related to you and ARE NOT previous employers.
I have made application for employment with the City of Sandersville. I authorize any persons or
organizations to give you any and all information concerning my previous employment, education,
or any other information they might have, personal or otherwise, whether or not it is in their
records, with regard to any of the subjects covered by this application, and I release all such parties
from all liability for any damage whatsoever for issuing same.
Furthermore, if I am employed by the City of Sandersville, I agree to the policies, rules, orders and
regulations of the government set forth in the City of Sandersville‘s Personnel system, employee
handbook, policies and procedures and ordinances; and acknowledge that these policies and
procedures, rules, and regulations may be changed, interpreted, withdrawn, or added to by the City
of Sandersville at any time, at the City’s sole option.
I further acknowledge that if I become employed with the City of Sandersville, my employment will
be at -will and may be terminated with or without cause at any time by me or the City of
Sandersville until such time that I am no longer on my initial trial period, and become a regular
If required by the City of Sandersville for the position which I am applying, I consent to undergo a
drug test, a physical examination, and/or a psychological examination after I have received a
conditional offer of employment, as deemed necessary.
THIS APPLICATION WILL REMAIN ACTIVE FOR NINETY (90) DAYS ONLY.
Should you become an employee with the City of Sandersville, your position may require random
May we contact your present employer?
Not presently employed
By checking this box you are agreeing to this authorization to contact prior employers. You must check this box even though if you have chosen for us not to contact your present employer.
As a condition of employment with the City of Sandersville, you may be required to submit to an
alcohol and controlled substance test. Employees who test positive for illegal drugs and/or alcohol
will be terminated. Employees must report any conviction under a criminal drug statute for such
violations. A report of the conviction must be made within five (5) days after the conviction.
I certify that the facts set forth in this application for employment are true and complete to the best
of my knowledge. I am aware that the falsification of this application or the omission of complete
information will result in disqualification, or upon discovery, termination of employment. The City
of Sandersville is hereby authorized to make any investigation of my prior educational and work
history. Finally, I agree that all records generated for purposes of employment are property of and
shall remain the sole and exclusive property of the City of Sandersville.
Resumes, letters of reference, etc. submitted with the application become property of the City of
Sandersville and will not be returned. The information you have provided on the application is
subject to public disclosure under the Georgia Open Records Act.
I certify that I am in compliance with O.C.G.A. 13-10-91 and that I am a
citizen, legal permanent resident or a qualified alien or nonimmigrant and I am eligible to work in
the United States.