I. GENERAL INFORMATION
   Name (First, MI, Last)
   Street Address
   City, State & Zip
   Email Address
   Social Security Number - -
   Home Phone Number - -
   Work Phone Number - -

IN CASE OF EMERGENCY, CONTACT
   Name
   Relationship
   Address
   City, State & Zip
   Phone - -

   Hours Desired
   (choose one)    Permanent        or       Temporary       or       Summer Only
   (choose one)     Full-Time         or        Part-Time

II. CHECK ONE
   U.S. Citizen
   Permanent Resident citizen of:

III. POSITION APPLYING FOR

IV. HAVE YOU HAD PREVIOUS PUBLIC SECTOR EMPLOYMENT?

Yes        No
   If yes, what office/agency
   What was your job title?

V. EDUCATION

HIGH SCHOOL
   Name of School
   Location of School
   Degree or Diploma Earned; Major

COLLEGE
   Name of School
   Location of School
   Degree or Diploma Earned; Major

GRADUATE SCHOOL
   Name of School
   Location of School
   Degree or Diploma Earned; Major

PROFESSIONAL TRAINING
   Name of School
   Location of School
   Degree or Diploma Earned; Major
Please list community or professional activities or organizations in which you participated; including office held or other leadership positions.

VI. EMPLOYMENT HISTORY
(Please list in chronological order, most recent first)

Most Recent Employment
   Employer's Name
   Employer's Address
   Employer's City, State & Zip
   Title/Position Held
   Length of Employment
   Duties

   Reason for leaving
   Immediate Supervisor & Title
   Salary - ANNUAL
   Starting $ K / year (enter in thousands) Leaving $ K / year (enter in thousands)

Employment 2
   Employer's Name
   Employer's Address
   Employer's City, State & Zip
   Title/Position Held
   Length of Employment
   Duties

   Reason for leaving
   Immediate Supervisor & Title
   Salary - ANNUAL
   Starting $ K / year (enter in thousands) Leaving $ K / year (enter in thousands)

Employment 3
   Employer's Name
   Employer's Address
   Employer's City, State & Zip
   Title/Position Held
   Length of Employment
   Duties

   Reason for leaving
   Immediate Supervisor & Title
   Salary - ANNUAL
   Starting $ K / year (enter in thousands) Leaving $ K / year (enter in thousands)

VII. REFERENCES
(Please list three references other than relatives)

Reference 1
   Name
   Street Address
   City, State & Zip
   Phone Number - -
   Occupation

Reference 2
   Name
   Street Address
   City, State & Zip
   Phone Number - -
   Occupation

Reference 3
   Name
   Street Address
   City, State & Zip
   Phone Number - -
   Occupation

VIII. MILITARY EXPERIENCE (if applicable)

   When Discharged:
   Highest Rank:

IX. BRIEFLY DESCRIBE YOUR CAREER OBJECTIVES

X. DESIRED ANNUAL SALARY

 $  K / year (enter in thousands)
    Referred by

XI. HAVE YOU BEEN CONVICTED OF ANY INFRACTION, OTHER THEN A MINOR TRAFFIC VIOLATION?

Yes        No
   If yes, please describe
Are you current on all taxes or court ordered obligations, personally or in conjunction with any business interests?

Yes        No
   If no, describe delinquency
Upload an optional resume and/or cover letter
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By clicking "Submit," I hereby attest the above information is true and complete to the best of my knowledge.  I also give permission to my current and former employers, references and educational institutions to release all information at their disposal to the County Auditor and to conduct a local background check with the proper law enforcement authorities.  I realize that providing false information on this application will result in my not being considered further for employment or should I be hired, in my dismissal from employment with the Franklin County Auditor's Office.

Written signature will be required at time of interview.

The Franklin County Auditor is an Equal Opportunity Employer