DEPARTMENT: Development Department POSITION: Senior Planner Note: All fields highlighted in Yellow are required. I. PERSONAL INFORMATION: First Name: Middle Initial: Last Name: Address: City: State: AL AK AR AZ CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA MA MD ME MI MN MO MS MT NE NH NJ NM NV NY NC ND OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code: Phone Number: Salary Desired:   Full-Time           Part-Time           Temporary II. LIST OF PRIOR EMPLOYERS, MOST RECENT FIRST: A. Firm: Phone Number: Address: Position Held: Employment Starting Date: Employment Ending Date: Leave blank if presently employed. Describe Duties: Reason for Leaving: Beginning Salary: Ending Salary: Supervisor: May we contact this employer? Yes     No B. Firm: Phone Number: Address: Position Held: Employment Starting Date: Employment Ending Date: Leave blank if presently employed. Describe Duties: Reason for Leaving: Beginning Salary: Ending Salary: Supervisor: May we contact this employer? Yes     No C. Firm: Phone Number: Address: Position Held: Employment Starting Date: Employment Ending Date: Leave blank if presently employed. Describe Duties: Reason for Leaving: Beginning Salary: Ending Salary: Supervisor: May we contact this employer? Yes     No III. EDUCATION: INSTITUTION ADDRESS DID YOU GRADUATE? DEGREE High School: Yes Junior College: Yes University/College: Yes Technical: Yes Other: Yes IV. BUSINESS/PROFESSIONAL REFERENCES: NAME ADDRESS PHONE POSITION HELD 1. 2. 3. V. GENERAL: A. Can you perform the essential functions of the position, with or without accommodations, for which you are applying? Yes     No      If no, please describe:            B. Person to contact in case of emergency Name: Telephone: Address: Relationship to you: C. Have you ever been convicted of a felony within the past seven years? Yes     No      If yes, provide felony and dates:            Under Section V, General, paragraph C: A conviction or deferment does not automatically disqualify you from employment, since the nature and date of the offense, the job to which you are applying, and other factors will be considered. D. Are you prevented from lawfully becoming employed because of Visa or Immigration Status? Yes     No E. Do you have a relative employed with Natrona County or one of its affiliated department boards? Yes     No      If yes, whom and in what capacity:            F. Summarize your special skills and qualifications: Keyboard speed (WPM): Operate a PC? Yes     No Calculator? Yes     No G: If applicable for the position: Driver's License Number: State of Issuance: Expiration date:     If applicable, do you have a valid commercial drivers license? Yes     No Natrona County, Wyoming, and its affiliated departments and boards, does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in the employment or provisions of service. All applicants for employment with Natrona County will be required to consent to and take a pre-employment Drug and Alcohol screening if a conditional offer of employment is made. The cost of the tests will be paid for by Natrona County. These tests will be held as confidential between the Applicant and the County. I understand that by checking below, and accepting employment (either part-time, full-time or temporary), I am an Employee at Will, whose employment may be terminated at any time, with or without cause, unless specifically modified by a written contract of employment or statutory provision. I certify that answers given herein are true and complete to the best of my knowledge; and I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of my employment, I understand that false or misleading information given in my application or interview(s) may result in disciplinary action that could lead to termination of my employment. I understand that prior to employment I will be subject to a criminal background investigation, and may be subject to a credit check and prior employment verification. Check here to acknowledge you have read the statement above      If applying for a Sheriff's Office position, are you 21 years of age? Yes     No I certify that answers given herein are true and complete to the best of my knowledge. Email certifies signature: Please enter your Email Address: Confirm Email Address: Attach a resume to this application by clicking on the Browse button. Attach a writing sample to this application by clicking on the Browse button. Writing samples are not required for Sheriff or Coroner positions. Error