Employment History - Please include the past 5 years of employment, including miliary service. Begin with your current employment and work back. You may attach a document with additional information to provide sufficient information. Reason for leaving and Salary must be completed.

Most Recent Employer

Previous Employer 1

Previous Employer 2

Previous Employer 3

Previous Employer 4

Education

Licenses/Certifications

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, willful omissions, or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release Jefferson County Drainage District No. 7 from any liability. Jefferson County Drainage District No. 7 may contact any references or former employer listed on this application. I understand that my employment is contingent upon successful completion of a conditional post-employment offer fitness for duty examination which will include a drug screen. This examination will be conducted by physicians of DD7’s selection. I certify that I will fully and truthfully answer any question asked by the physicians or staff. I understand that a positive result from the drug screen will eliminate me from consideration from any DD7 job for one year. I acknowledge and understand that my employment is at the discretion of the General Manager, and that Jefferson County Drainage District No. 7 is an “at-will” employer. Therefore, any employee may resign at any time, just the District may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.