Employment ApplicationStep 1 of 911%THE CLEAR LAKE CITY WATER AUTHORITY IS AN AT-WILL EMPLOYERCOMPLETING THE APPLICATIONResumes will not be accepted as a substitute for applications.Incomplete applications will not be considered.All statements made on this application are subject to verification.Read and complete the Clear Lake City Water Authority Employment Application.Read and complete the Clear Lake City Water Authority Terms of Application for Employment.Read and complete the Clear Lake City Water Authority Authorization to Obtain Information.STATUSIf your application meets the minimum required qualifications for the position you are applying, a company representative may contact you to schedule an interview. Thank you for your interest in employment with the Clear Lake City Water Authority.HIRING POLICYThe Clear Lake City Water Authority requires drug screening upon offer of employment, random, and post-accident.The Clear Lake City Water Authority is an E-Verify employer.Applicants are considered for positions, and all employees are treated similarly during employment without regard to race, creed, color, sex, age, national origin, marital or veteran status, disability or any other legally protected status. The Clear Lake City Water Authority is an Equal Opportunity Employer.Reasonable accommodations for individuals with disabilities will be made, when necessary, during the application process.Any application or supplement containing any misrepresentation by the applicant will be cause for cancellation of the application process or termination if they have been hired by CLCWA.Applications for employment will expire after one year unless otherwise notified.Clear Lake City Water Authority TERMS OF APPLICATION FOR EMPLOYMENTI have reviewed the essential job functions and minimum qualifications for the position for which I am applying. I am aware that this application may be subject to public disclosure unless an exception under the Texas Public Information Act is applicable.The information in this application is accurate, complete, and is subject to verification by the Clear Lake City Water Authority (CLCWA). I understand that if I have given any false information in this application or if I have omitted any material facts, I may be disqualified from employment with the CLCWA or if hired, I may be discharged immediately upon discovery of such false statements or omissions. Applicants are considered for positions, and employees all are treated similarly during employment without regard to race, creed, color, sex, age, national origin, marital or veteran status, disability or any other legally protected status. The Clear Lake City Water Authority is an Equal Opportunity Employer.PLEASE READ CAREFULLY and then initial, or have initialed on your behalf, each statement below to indicate you do understand and agree with the statement, I HAVE READ, UNDERSTAND AND AGREE THAT:1. I authorize the CLCWA, in considering my employment, to make any contacts it deems necessary (including, but not limited to: employers, agencies of public record or credit reporting agencies as followed by the Fair Credit Reporting Act). I authorize such investigation and the giving and receiving of any information requested by the CLCWA to verify all data given in my application for employment, related documents, or oral interviews. I understand that falsification, misrepresentation or omission of facts on this application or any other accompanying documents will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered. I release from liability any person giving or receiving any such information, including any liability arising from the employer’s verification of prior employment history, criminal record, references and any other background information pertaining to the applicant. * Required2. Only the Board of Directors has the authority to enter into any agreement for employment for any specified period of time, and that no such agreement has been offered to anyone as part of this application process. * Required3. I understand that any offer of employment is contingent upon completing Form I-9 (Immigration and Naturalization Employment Eligibility Verification Form) and providing original documents required by the Immigration and Naturalization Service to verify my identity and employment eligibility. * Required4. If requested, I agree to a search of any locker or premises assigned to me and I hereby waive all claims for damages on account of such examination. * Required5. I consent to medical or psychological exams required or requested by the CLCWA as permitted under applicable law. I understand that employees will be subject to random drug and alcohol testing throughout their employment. I understand the CLCWA expects employees to report for work fit for duty, free from effects of drug use, including alcohol. * Required6. I authorize any physician, medical provider or medical facility to release any information that may be necessary to determine my ability to perform the essential functions of my job after I receive an employment offer or during the course of my employment with the CLCWA. * Required7. If I become employed by the CLCWA, such employment is for an indefinite period of time and the CLCWA can change wages, hours of employment, shift assignments, benefits, positions, and conditions of employment at any time. * Required8. If hired, I can be terminated or transferred to another position with or without cause at any time at the option of the CLCWA. * Required9. This application is the property of the CLCWA and will become a part of my personnel file if I am accepted for employment. I further understand that it is an application for employment and that no employment is being offered and that the CLCWA, in receiving this application, has made no contract of employment with me and has not in any way guaranteed my future employment. Further, no oral or implied agreements differing from written policy or authorized salary plans will be honored. * Required10. I understand that employment eligibility includes applicable testing such as criminal history check, human performance evaluation, agility test and the finding may be used in the employment decision. If I require accommodation when the CLCWA administers pre-employment tests, I will notify Human Resource in writing of any accommodations when I submit my application. * Required11. CLCWA is an “at-will” employer and does not in any manner guarantee my future employment in any particular position and, indeed, the CLCWA reserves both the right to terminate me or any employee in accordance with the law or to transfer me, or any employee to other positions as situations dictate. * Required12. I understand that the Clear Lake City Water Authority may encounter emergency situations and I may be required to provide services or perform duties for the benefit of the general public during emergency situations. These may include services or duties different from those performed in the usual course and scope of your job. In the event of an evacuation you maybe be required to remain to perform needed services. * Required13. I understand that the Clear Lake City Water Authority is an “at will” employer as defined by applicable laws. * RequiredI, the undersigned, certify that I have read and fully comprehend this form in its entirety and that the information provided is true and complete.Full Name * RequiredElectronic SignatureDate - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY INSTRUCTIONS: Applicants must complete all the blanks accurately and completely to be considered. All information provided is subject to verification. A FALSE STATEMENT OR OMISSION MAY RESULT IN DISQUALIFICATION FOR EMPLOYMENT OR DISCHARGE, IF EMPLOYED. The Clear Lake City Water Authority is an Equal Opportunity Employer and prohibits discrimination in employment because of race, color, sex, religion, national origin, age, disability and any other protected status under the State or Federal guidelines. No question on this application is intended to secure information to be used for discriminatory purposes.Position Applying For: * RequiredSelect a PositionAny PositionApplication Date: 10/24/2020Check all types of work you will accept: * Required Full-Time Part-Time Temporary Summer Day Evenings Nights WeekendsDate available to begin work - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Personal InformationName * RequiredSocial Security Number * RequiredName as it appears on your social security card * RequiredAddress * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email * Required Home Phone NumberCell Phone NumberDrivers License Number * RequiredState * RequiredAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificClass * RequiredABCDo you have a commercial drivers license? * RequiredYesNoCheck all applicable license endorsement(s) * Required Trailer Tank Hazmat Combination OtherSpecify * RequiredPersonal Information (Page 2)Have you been convicted or placed on deferred disposition for any traffic violations within the past three years? * RequiredYesNoDate - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Violation * RequiredDate - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY ViolationDate - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY ViolationHave you ever served in the armed services? * RequiredYesNoBranch of Service * RequiredFrom - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY To - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Have you ever pled guilty or no contest, been convicted, or placed on community supervision to a felony or misdemeanor offense in a civilian or military court? * RequiredYesNoDisposition Date - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY State * RequiredAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWhat were you charged with? * RequiredResult * RequiredDisposition Date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWhat were you charged with?ResultDisposition Date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWhat were you charged with?ResultNOTE: PRIOR TO EMPLOYMENT, APPLICANTS MAY BE INVESTIGATED AS TO CONVICTIONS FOR PRIOR CRIMINAL OFFENSES. Answering "yes" may not automatically disqualify you, but a false statement or omission of information will. A prior conviction will be considered in relationship to the requirements of the job for which you are applying. Failure to answer the above questions truthfully may result in immediate dismissal.EducationHave you earned a high school diploma or GED? * RequiredYesNoDid you attend a college, business or technical school? * RequiredYesNoSchool * RequiredCourse/Major * RequiredHours Completed * RequiredDegree Type * RequiredSchoolCourse/MajorHours CompletedDegree TypeSchoolCourse/MajorHours CompletedDegree TypeLicensesIf a license, certificate, or other authorization is required or related to the position you are applying for, complete the following:License 1License/CertificationIssued by (State or Authority)Issuing Authority Location (City, State)License NumberExpiration Date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Date Issued - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY License 2License/CertificationIssued by (State or Authority)Issuing Authority Location (City, State)License NumberExpiration Date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Date Issued - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY License 3License/CertificationIssued by (State or Authority)Issuing Authority Location (City, State)License NumberExpiration Date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Date Issued - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY SkillsSpecial Qualification and Skills: List qualifications and skills you possess which are required for the job describes in the official job announcement and machines or office equipment you can use, such as printing or graphics equipment, computer equipment, types of software and hardware, typing words per minute, ect. Indicate any training you have which is directly related to the job. * RequiredLanguages other than EnglishProficiency Speak Read WriteLanguages other than EnglishProficiency Speak Read WriteLanguages other than EnglishProficiency Speak Read WriteWork InformationCan you provide proof of both your identity and your right to work in the United States? * RequiredYesNoHave you ever been employed at the Clear Lake City Water Authority? * RequiredYesNoIf yes, list dates of employment, position held and name used if different from the name on this application * RequiredDo you have any relatives working for or holding office for the Clear Lake City Water Authority? * RequiredYesNoIf yes, list name(s) and relation. * RequiredExperiencePosition 1Name of Employer * RequiredPhone Number * RequiredAddress * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code From - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY To - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Type of Work * Required Full-Time Part-Time Temporary SummerStarting Salary * RequiredEnding Salary * RequiredSpecific reason for leaving * RequiredNumber of employees supervised, if any: * RequiredJob Title Held * RequiredJob Duties * RequiredName of Immediate Supervisor * RequiredTitle * RequiredPhone Number * RequiredMay we contact your previous supervisor for a reference? * RequiredYesNoPosition 2Name of EmployerPhone NumberAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code From - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY To - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Type of Work Full-Time Part-Time Temporary SummerStarting SalaryEnding SalarySpecific reason for leavingNumber of employees supervised, if anyJob Title HeldJob DutiesName of Immediate SupervisorTitlePhone NumberMay we contact your previous supervisor for a reference?YesNoPosition 3Name of EmployerPhone NumberAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code From - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY To - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Type of Work Full-Time Part-Time Temporary SummerStarting SalaryEnding SalarySpecific reason for leavingNumber of employees supervised, if anyJob Title HeldJob DutiesName of Immediate SupervisorTitlePhone NumberMay we contact your previous supervisor for a reference?YesNoPersonal ReferencesPersonal Reference 1Name * RequiredAddress * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Daytime Phone Number * RequiredEmail * Required Years Acquainted * RequiredPersonal Reference 2Name * RequiredAddress * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Daytime Phone Number * RequiredEmail * Required Years Acquainted * RequiredPersonal Reference 3Name * RequiredAddress * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Daytime Phone Number * RequiredEmail * Required Years Acquainted * RequiredCAPTCHA