Fillable Printable Employment Application - Alabama

Employment Application - Alabama

Employment Application

ADMINISTRATIVE OFFICE OF COURTS

RETURN TO:

Human Resources Division

Administrative Office of Courts

300 Dexter Avenue

Montgomery, AL 36104-3741

We Are An Equal Opportunity Employer

1. When completing this appli cation, list the spe cific job cla ss(es) with the Unified Judicial System in which you are

interested. Information on the type of jobs available within the system can be obtained from job announcements

which are available in any Alabama State Employment Service Office, the Circuit Clerk's Office in any State

Courthouse, the Human Resources Division of the AOC at the above address, and on-line at http:\\humanresources.

alacourt.gov.

2. ALL BLANKS MUST BE TYPED OR PRINTED IN INK. PAGES 2 AND 3 MUST BE SIGNED AND DATED.

3. ALL application

s must be mailed directly to the Administrative Office of Cour

ts, Human Resource s Division, 300

Dexter Avenue, Montgomery, AL 36104-3741, by the applicant. Applications must be received by the Human Resources

Division by the close of business on the last date for this job announcement.

4. Your appl

ication will be used to dete

rmine eligibility for the class(es) for which you are app lying. Your application will

be accepted or rej ected based on the training and experience standards published in the job announcement issued by

the Human Resources Division of the Administrative Office of Courts.

5. If the position applied for requires written examination, you will be notified of your score(s) within approxi mately six

weeks after taking the written examination(s). Standi ng on a register will not be given for those classes which are

open for continuou s recruitment, beca use your position may change as names are deleted or new n ames are added

to the register. NOTE: If you are determined to be unqualified for any class, you will be notifie d by mail.

6. REMOVAL OF ELIGIBLES FROM REGISTER(S): An applicant's name will be removed from the register under any of

the following conditions:

a. Written evidence that the eligible cannot be located by postal authorities.

b. Written evidence that the eligible no longer desires appointment to the class.

c. After the eligible has three times failed to reply, or upon being certified for a job vacancy, has declined an offer of

employment.

d. Written evidence that the applicant falsified his or her appli ca t ion, or is otherwise unsuitable for employment.

7. Failure to give complete information will result in the return and disqualification of your application.

8. It is the responsibility of the applicant to notify the Human Resources Division of the Administrative Office of Courts

whenever there is a chan ge of address. The U.S.Postal Service will forward mail for a limited time only.

Employment Application The Administrative Office of Courts is an Equal Opportunity Employer

PART I. – APPLICANT IDENTIFICATION

Social Security Number

Email Address _________________________________________

Last Name

First Name M.I. Area Code Phone Numbers

Work:

Home :

Mailing Address (Street Number / Name , Apt. Designation or RFD)

City County

State Zip Code Yes No

Are you currently working within the Unified

Judicial System and applying for a promotion?

PART II. – INDICATE ANSWER BY PLACING AN “X” IN THE PROPER BOX

1. Have you ever been discharged or forced to resign from a position? Yes No

2. Will you accept employment involving travel? Yes No

3. May inquiries be made of your present and/or past employers regarding character, qualifications, or work performance? Yes No

4. Have you ever been convicted of a law violation other than a “minor” traffic offense? If yes, explain charges, where convicted and dates below.

Yes No ___________________________________________________________________________________________________

__________________________________________________________________________________________________________________

5. Have you filed an application for employment in the Alabama Unified Judicial System within the past year? If yes, list class(es) and date below.

Yes No ____________________________________________________________________________________________________

How did you find out about this job opening?

Newspaper CareerBuilder.com Monster.com

Friend

TV/Radio UJS Employee Other _____________________________

PART III. – USE THIS SPACE TO CLAIM VETERAN’S PREFERENCE – CHECK TYPE AND ATTACH DOCUMENTS

1. Veteran (Attach DD Form 214 or other document showing service dates.)

2. Disabled Veteran (DD214 and V.A. Certifications of service connected disability.)

3. Veteran’s Surviving Spouse (Veteran’s Documents, marriage, and death certificates.)

4. Spouse of Disabled Veteran (Disabled Veteran’s Documents and marriage certificate.)

Please Read: Persons honorably discharged from the Army, Navy, Air Force, Marine Corps, or Coast Guard are entitled to five points veteran’s

preference. The surviving spouse of such person w

ho died in line of duty or the surviving spouse of a veteran who meets requirements of the

preceding sentence is entitled to ten points preference; a disabled veteran is entitled to ten points preference if he/she is eligible to receive

compensation for a service connected disability; and the spouse of a disabled veteran is entitled to ten points if the veteran cannot qualify

because of his/her service

connected disability.

PA RT I V. – EMPLOYMENT DATA – INDICATE NO MORE THAN THREE JO B CLASSES FOR WHICH YOU ARE APPLYING

JOB CLASS TITLE JOB CODE

I will accept TEMPORARY PART-TIME FULL-TIME employment. I will be available for work on _______________________________

Month Day Year

Alabama county where I am primarily interested in working:

1.___________________________________________________

(Optional) Other Alabama counties where I will accept employment:

2.______________________________ 3. ________________________

_______________________________ Items below to be completed by Human Resources Division _____________________________________

1 .

DO NOT WRITE HERE – FOR USE OF HUMAN RESOURCES DIVISION

Job Code 0

Evaluation

Average

Training &

Experience

Written

Exam

Vet.

Pref.

TOTAL MO DAY YR

Note: A felony conviction will bar employment in law enforcement and certain judicial positions. The disclosure of a misdemeanor will not automatically

result in disqualification from employment. Criminal histories will be submitted to the National Crime Information Center (NCIC) for verification. Failure

to disclose a conviction may be considered grounds for disqualification. For these reasons, applicants should be careful to disclose ALL criminal

convictions.

State of Alabama U.J.S. Form No.PERS 22 Rev.5/12

PART V. EDUCATION – Give Your Complete Educational History Employment Application

Did you graduate from high school or pass the high school equivalency test? Check your answer Yes No

DATES

From To

LEVEL NAME & LOCATION

Mo. Yr.

Mo.

Yr.

YEAR of

COMPLETION

CRED.

HOURS

DID

YOU

GRAD?

DEGREE OR

DIPL. & DATE

MAJOR

SUBJECT

Elementary or

High School

College

Graduate or

Professional

Other Education,

Intern., Etc.

PART VI. – CERTIFICATIONS, SKILLS, AND COURSES

1. List field of work for which you are licensed, registered, or certified. Give date and source of issuance:

2. List typing and shorthand skills, machines you can operate, and other skills in which you are proficient:

3. If the position applied for calls for specific courses, indicate courses and credits received:

PART VII. – EMPLOYMENT – This section must be completed even if a resume is attached.

Answer questions for each period of employment; include previous employment wi th the State of Alabama, military service, and related

volunteer work. Failure to give complete information will result in rejection of your application. Begin with your present or last position. If

more space is needed, use a continuation sheet (page 3).

Starting

A. Title of present or most recent position __________________________________________ Salary _____________Last Salary___________

Name & Title of supervisor __________________________________ # EEs Applicant supv. _____________

Employer __________________________ Address _____________________________________________

Duties _________________________________________________________________________________

_______________________________________________________________________________________

Reason for leaving _______________________________________________________________________

Date employed

Date separated

Full-time

Yrs. Mos.

Part-time

Yrs. Mos.

If part-time, no. of hrs.

worked /wk.

Starting

B. Title of next most recent position _______________________________________________ Salary _____________Last Salary___________

Name & Title of supervisor __________________________________ # EEs Applicant supv. _____________

Employer ______________________________ Address______ ____________________________________

Duties _________________________________________________________________________________

_______________________________________________________________________________________

Reason for leaving _______________________________________________________________________

Date employed

Date separated

Full-time

Yrs. Mos.

Part-time

Yrs. Mos.

If part-time, no. of hrs.

worked /wk.

Starting

C. Title of next most recent position _______________________________________________ Salary _____________Last Salary___________

Name & Title of supervisor __________________________________ # EEs Applicant supv. _____________

Employer _____________________________ Address ___________________________________________

Duties _________________________________________________________________________________

_______________________________________________________________________________________

Reason for leaving _______________________________________________________________________

Date employed

Date separated

Full-time

Yrs. Mos.

Part-time

Yrs. Mos.

If part-time, no. of hrs.

worked /wk.

CERTIFICATION A ND CONDITION OF EMPLOYMENT AGREEMENT

I certify that the statements on or attached to this application are true and correct to the best of my knowledge. I know that any

false statements may cause me to be denied employment, the chance for testing, to be removed from an employment register,

or to be released from employment. I authorize the release of all prior employment, military service, academic/school and

criminal records. If employed, I agree, consistent with applicable laws, to receive compensatory time off in lieu of overtime cash

compensation. I also certify (if applicable) that I have enclosed proof of my service registration in compliance with Act 91-584.

Date ____________________________________ Applicant’s Signature : ________________________________________________

State of Alabama U.J.S. Form No.PERS 22 Rev.5/12

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EMPLOYMENT APPLICATION

Continuation Sheet (page 3)

Date

D. Title of position __________________________________________________________________________ Ending Salary ____________________

Name & title of supervisor _____________________________________________________________# EEs Applicant supv. ________________

___

Name of employer __________________________________________________Address ______________________________________________

Duties ______________________________________________________________________________

___________________________________________________________________________________

Reason for leaving ____________________________________________________________________

___________________________________________________________________________________

Date employed

Date separated

Full-time

Yrs. Mos.

Part-time

Yrs. Mos.

If part-time, no. of hrs.

worked /wk.

E. Title of position __________________________________________________________________________ Ending Salary ____________________

Name & title of supervisor _____________________________________________________________ # EEs Applicant supv. ___________________

Name of employer ________________________________________________ Address ________________________________________________

Duties ______________________________________________________________________________

___________________________________________________________________________________

Reason for leaving ____________________________________________________________________

___________________________________________________________________________________

Date employed

Date separated

Full-time

Yrs. Mos.

Part-time

Yrs. Mos.

If part-time, no. of hrs.

worked /wk.

F. Title of position __________________________________________________________________________ Ending Salary ____________________

Name & title of supervisor _____________________________________________________________# EEs Applicant supv. ___________________

Name of employer _________________________________________________ Address _______________________________________________

Duties ______________________________________________________________________________

___________________________________________________________________________________

Reason for leaving ____________________________________________________________________

___________________________________________________________________________________

Date employed

Date separated

Full-time

Yrs. Mos.

Part-time

Yrs. Mos.

If part-time, no. of hrs.

worked /wk.

G. Title of position __________________________________________________________________________ Ending Salary ____________________

Name & title of supervisor _____________________________________________________________ # EEs Applicant supv. ___________________

Name of employer ____________________________________________________ Address ____________________________________________

Duties ______________________________________________________________________________

___________________________________________________________________________________

Reason for leaving ____________________________________________________________________

___________________________________________________________________________________

Date employed

Date separated

Full-time

Yrs. Mos.

Part-time

Yrs. Mos.

If part-time, no. of hrs.

worked /wk.

CERTIFICATION AND CONDITIONS OF EMPLOYMENT AGREEMENT

I certify that the statements on or attached to this application are true and correct to the best of my knowledge. I know that any

false statements may cause me to be denied employment, the chance for testing, to be removed from an employment register, or to

be released from employment. I authorize the release of all prior employment, military service, academic/school and criminal records.

If employed, I agree, consistent with applicable laws, to receive compensatory time off in lieu of overtime cash compensation. I also

certify (if applicable) that I have enclosed proof of my service registration in compliance with Act 91-584.

Date: ____________________________ _______________________________________________________________

Applicant’s Signature

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

State of Alabama U.J.S. Form No.PERS 22 Rev.5/12

EQUAL EMPLOYMENT OPPORTUNITY REPORTING AND RESEARCH

(Federal Employment Opportunity Reporting and Research requires the following Information which is not used to evaluate your

application – and is filed separately.)

Month Day Year Male Female Yes No

Date of Birth Sex U.S. Citizen

1. White 4. Black

Oriental/Asian 5. Hispanic/Latino

Social Security #

3. Native American

*Act 91-584 mandates that persons required to register with the U.S. Selective Service System (i.e., male citizens of the U.S.

between the ages of 18 and 26) furnish proof of registration before any offer of employment, promotion, or advancement may be

made by the State of Alabama.

A copy of the Selective Service registration must accompany this application.

COMPLETE THIS SECTION IN ORDER TO BE SCHEDULED FOR WRITTEN EXAMS

Written examinations will be given periodically in the cities listed below, indicate your 1

, 2

and 3

choices of

test dates.

01 ( ) Florence

02 ( ) Huntsville

03 ( ) Gadsden

04 ( ) Birmingham

05 ( ) Tuscaloosa

06 ( ) Montgomery

07 ( ) Dothan

08 ( ) Mobile

If you qualify, you will receive notification of test date, time, and location.

IMPORTANT

PLEA SE READ

Applicants will be notified of their score(s) within approximately six weeks after taking

the written examination(s). The standing on the registers for those passing

examinations for classes which are open for continuous recruitment (see job

announcement) will not be given due to the fact that relative positions will change as

new names are added to or deleted from these registers.

State of Alabama U.J.S. Form No.PERS 22 Rev.5/1

WE ARE AN EQUAL OPPORTUNITY EMPLOYER