911 Employment Application 911 Application Employment application for Johnson County Public Safety Communications Step 1 of 3 33% Your Personal InformationYour Name First Last Your Email Address Enter Email Confirm Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Your PhoneSocial Security Number(Required)SSNDriver's License NumberOLN Position You're Applying ForPosition You're Applying For 911 Telecommunicator 911 Shift Supervisor Quality Assurance / Training Coordinator CAD/GIS Administrator 911 Deputy Director If you are under 18 years of age, can you provide required proof of eligibility to work?(Required) Yes No Have you ever filed an application with us before? Yes No Have you ever been employed with Johnson County before? Yes No If you have previously been employed with Johnson County please provide the dates of employmentAre you currently employed? Yes No May we contact your employer? Yes No Are you prevented from lawfully becoming employed in this country because of visa or immigration status? Yes No Are you currently on "lay-off" status and subject to recall? Yes No Can you travel is the position requires? Yes No Will you submit to a drug and alcohol screen if required for the position? Yes No Have you ever pleaded guilty to or "no-contest" to or been convicted of a felony or misdemeanor that has not been expunged by a court? Yes No If Yes, please give dates and explainWill you need additional accommodations to perform your job? Yes No If Yes, please explainOn what date would you be available for work? MM slash DD slash YYYY What skills do you possess that are relevant to the position you have applied for?Please check which you are available to work Full-Time Part-Time Shift Work Temporary Select AllEducationElementaryName and Address of SchoolCourse of StudyYears CompletedDiploma / Degree Add RemoveHigh SchoolName and Address of SchoolCourse of StudyYears CompletedDiploma / Degree Add RemoveUndergraduate CollegeName and Address of SchoolCourse of StudyYears CompletedDiploma / Degree Add RemoveGraduate / ProfessionalName and Address of SchoolCourse of StudyYears CompletedDiploma / Degree Add RemoveOther (Specify)Name and Address of SchoolCourse of StudyYears CompletedDiploma / Degree Add RemovePlease list any foreign languages you can speak, read and/or writePast ResidenceList previous addressesStreet AddressCityStateZip Code Add RemoveStreet AddressCityStateZip Code Add RemoveStreet AddressCityStateZip Code Add RemovePrevious Employment (please start with your current or most recent position)1. EmployerPlease list your previous employers, the dates you worked and the position you heldName of EmployerAddress of EmployerDates EmployedPositionPhoneHourly Rate / Salary Add RemoveWork PerformedReason for Leaving Add Remove2. EmployerPlease list your previous employers, the dates you worked and the position you heldName of EmployerAddress of EmployerDates EmployedPositionPhoneHourly Rate / Salary Add RemoveWork PerformedReason for Leaving Add Remove3. EmployerPlease list your previous employers, the dates you worked and the position you heldName of EmployerAddress of EmployerDates EmployedPositionPhoneHourly Rate / Salary Add RemoveWork PerformedReason for Leaving Add Remove4. EmployerPlease list your previous employers, the dates you worked and the position you heldName of EmployerAddress of EmployerDates EmployedPositionPhoneHourly Rate / Salary Add RemoveWork PerformedReason for Leaving Add Remove Other Qualifications Computer Phone System Microsoft Word Microsoft Excell Computer Aided Dispatch Systems Other QualificationsList other qualifications you possess that you believe could help you in your performance the job you are applying forAdditional InformationList Professional, trade, business, or civic activities and offices held.(You may exclude membership that would reveal gender, race, religion, national origin, age, disability, or other protected status.Describe any specialized training, apprenticeship, skills, extra-curricular activities, and military experience that may relate to the position for which you are applyingProvide any additional information you feel may be helpful to us in considerint your applicationAre you capable of performing in a reasonable manner the activities involved in the job or occupation for which you have applied?(Do not answer the following questions unless you understand the requirements of the job for which you are applying) Yes No I do not understand the requirements References (Non-Related) Reference 1NamePhone NumberAddress Add RemoveReference 2NamePhone NumberAddress Add RemoveReference 3NamePhone NumberAddress Add RemoveReference 4NamePhone NumberAddress Add RemoveApplicants StatementI certify under the penalties of perjury that the information given herein is true and complete to the best of my knowledge. I authorize Johnson County to investigate all statements contained in this application for employment as may be necessary in arriving at an employment decision. I authorize Johnson County to conduct a background investigation, which may include, but is not limited to: Criminal History, Past Residence History, and Job History. This application for employment shall be considered active for a period not to exceed 1 year. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether applications are being accepted at that time. I understand that I may be required to submit to a drug/alcohol test prior to being considered for this position. I also understand that this information will be kept confidential but can have an effect on my employment with Johnson County. I further understand that to be considered for the position for which I am applying I waive my right of privacy with respect to the results of this test. I hereby Understand and acknowledge that unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge the employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by the County Commissioners. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge and possible prosecution. I understand, also, that I am required to abide by all rules and regulations of the employer. Signature(Required)Date MM slash DD slash YYYY Upload Your ResumeUpload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB.