Employment Application

This application must be completed in full, even if a resume is attached.

The City of Excelsior Springs is an Equal Opportunity Employer. We consider all applicants on the basis of qualifications and job-related requirements and criteria, without regard to race, color, national origin, ethnic origin or ancestry, religion, gender/sex, pregnancy, disability, age, military status, and any other characteristic protected by law.

    Telephone number(s) where we can contact you:

    Are you 18 years of age or older?

    For Police Officer Applicants Only: Are you 21 years of age or older?

    Are you legally eligible to work in the United States and able to provide required documentation upon employment?

    (Failure to provide required documentation can result in dismissal.)

    Have you ever been convicted of, or pled guilty or "Nolo Contendere" to a felony or misdemeanor?*

    Offense 1:

    Offense 2:

    Offense 3:

    Offense 4:

    *Conviction will not automatically disqualify you from employment consideration. We will consider the nature of the offense in relation to the job for which you are applying.


    Are you employed now?

    If "yes", may we contact your present employer for reference?

    Are you willing to work a rotating shift?

    Have you ever applied for a job with the City of Excelsior Springs before?

    Have you ever been employed by the City of Excelsior Springs before?

    Are you related to any employee or elected official of the City of Excelsior Springs?

    EDUCATION High School:

    College or University:

    Vocational or Trade School:

    Graduate School:

    (Start with your present or most recent employment and provide ALL information requested, even if a resume is attached.)

    (List the names of three persons who you have known at least one year. Do not include family members.)

    I certify that the statements contained in the application are true and complete to the best of my knowledge. I understand that, if hired, false or misleading information given in my application, resume or interview(s) may result in immediate dismissal. I authorize the City of Excelsior Springs to verify all statements contained in the application for employment and to make reference and background checks as its representatives deem necessary. You are hereby authorized to make any investigation of my personal character, academic records or employment history, and I release all parties from any claim arising in connection with their giving the same to you. In understand and agree that I may be required to take one or more physical examinations, including drug and alcohol screens, as a condition of hiring or continued employment. I agree to consent to take such examination(s) at such time as designated by the City of Excelsior Springs. I further understand that if I am employed, I will be at "at will" employee, free to resign without notice or to be dismissed without notice.

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