Position applying for: * Date: * How did you find out about this position? * Newspaper Website Friend Employer Other Name: * (Last) (First) ( Middle Initial) Address Address: * Street City * State * Zip * Telephone: * (Home)(Business)(Cell) Have you ever worked for the City of Heber Springs before? * Yes No If yes, give dates of employment and job/department: Are you at least 18 years old or older? * Yes No (Note: At date of hire, Police officers must be at least 21 years of age.) Have you ever been convicted of a felony? * Yes No (Conviction will not necessarily disqualify an applicant for employment other than public safety. Factors such as age and time since the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. Civil Service Commission rules require that Public Safety employees have no felony convictions) If yes, give date and details: Name and relationship of relatives employed by the City of Heber Springs: Have you ever served in the Armed Forces or National Guard of the United States? * Yes No If yes, list list Branch, Dates Served Highest level of education: * High School 9 High School 10 High School 11 High School 12 College Associates Bachelors Higher References: Name: Address: Occupation: Phone Number: References: Name Address: Occupation: Phone Number: Leave this field blank
