Form Center

Personal Information

First Name*
Middle Name
Maiden Name
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Are you at least 18 years of age?*
1. Yes
1. No
Are you eligible to work in the United States?*
1. Yes
1. No
Have you ever been discharged or asked to resign from any job?*
1. Yes
1. No
Please note, a "yes" answer does not necessarily disqualify an applicant.
If you answered yes, please provide details below.
If you served in the Armed Forces, did you receive other than an honorable discharge?*
1. Yes
1. No
Please note, a "yes" answer does not necessarily disqualify an applicant.
If you answered yes, please provide details below.
Are you related to any Fort Mill Town Council member or Town employee?*
1. Yes
1. No
If you answered yes, please provide name and relationship below.
Do you have a valid driver's license?*
1. Yes
1. No
If yes, explain type below, including if you have a CDL (commercial) license, what class and which state.
Have you had any vehicle accidents or moving violations during the past three years?*
1. Yes
1. No
Please note, a "yes" answer does not necessarily disqualify an applicant.
If you answered yes, please provide details below, including how many accidents or violations. .
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Position Information

Which position are you applying for?*
Date you are available to begin work*
Date you are available to begin work
Type of employment desired*
1. Full Time Only
1. Part Time Only
1. Full- or Part-time
Salary desired*
Hours of work (per week) desired*
How did you hear about the position?*
Describe experience you may have with equipment, office machines, computers or software that you feel is applicable to the position for which you are applying.
Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.
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Education

High School
Address
Did you graduate?
1. Yes
1. No
College
Address
Degree OR number of years completed
Did you graduate?
1. Yes
1. No
Other
Address
Degree OR number of years completed
Did you graduate?
1. Yes
1. No
Other
Address
Degree OR number of years completed
Did you graduate?
1. Yes
1. No
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Employment History

(From most recent, list your last three positions)
Company*
Position*
Supervisor
Phone Number*
May we contact your previous supervisor for a reference?*
1. Yes
1. No
Address
Responsibilities*
Employed From - To (Date)*
Salary*
Reason for leaving*
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Salary
Reason for leaving
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Salary
Reason for leaving
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References

Please list at least two professional references.
Full Name*
Relationship*
Company*
Phone Number*
Email address
Full Name*
Relationship*
Company*
Phone Number*
Email address
Full Name
Relationship
Company
Phone Number
Email address
Applicant Demographic Data
Federal regulations require the Town to collect data regarding the applicants' race, sex, and national origin for purposes of complying with federal non-discrimination laws. We are asking you to voluntarily disclose this data to help the Town comply with this obligation. Completion of this portion of the application is voluntary. This data will not be considered by the Town in evaluating your application, nor will your refusal to fill out this portion of the application be held against you.
Please indicate your gender:
1. Male
1. Female
Please indicate your ethnicity (race or national origin)
1. White
2. Hispanic or Latino
3. Black or African American
4. American Indian or Alaskan Native
5. Asian
6. Native Hawaiian or Other Pacific Islander
7. Two or more races
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Disclaimer & Signature

Town of Fort Mill Employment Application- Applicant's Certification
Please read carefully!
In exchange for the consideration of my job application by the Town of Fort Mill (hereinafter called “Town”), I agree that:
Neither the acceptance of this application nor subsequent entry into any type of employment relationship, either in the position applied for or any other position, nor the contents of employee handbooks, manuals, benefits plans, or policy statements creates an actual or implied contract of employment. Likewise, no such circumstances or documents confer any right to remain an employee of the Town or to change in any respect the employment-at-will relationship between the Town and the undersigned. Both the undersigned and the Town many end the employment relationship at any time, without notice or reason. If employed, I understand that the Town may unilaterally change or revise its benefits, policies and procedures and such changes may include reduction in elimination of benefits.
I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omissions of facts may result in my application not being further considered or, if employed, in termination of my employment. I hereby give the Town permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Town from any liability as a result of such contact.
I understand that any offer of employment wit the Town is conditioned on the following and that the Town findings with regard to any such condition may result in withdrawal of the employment offer.
1. All positions- A negative test result for illegal or unauthorized drugs.
2. Applicants applying for driving positions may be required to provide at least a three (3) year driving history from the relevant department(s) of motor vehicles at the applicant’s expense and prior to the interview. Any applicant who fails to provide the required vehicle license check may not be considered for employment.
3. Criminal Records and/or Consumer (Credit) checks are conducted on all applicants tentatively selected for hire, and any offer of employment may be revoked, or any employment terminated, based on the results of the checks.
I certify that all information that I have provided in order to apply for and secure work with this employer is true, complete and correct.
I understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard.
I understand that any information provided by me is found to be false, incomplete or misrepresented in any respect, may result in elimination of my further consideration for employment or, if employed, in my termination from employment.
Applicant Signature*
Today's Date*
Today's Date
The Town is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, age, genetic information, pregnancy or disability. Your opportunity for employment with the Town depends solely on your qualifications. Thank you for applying for employment with the Town of Fort Mill.

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