Form Center

Contact Information

EMPLOYMENT APPLICATION
213 N. Main
Republic, MO 65738
Phone: (417) 732-3110
Fax: (417) 732-3149
www.republicmo.com
The City of Republic is an equal opportunity employer and it is the policy of the City that all employment applicants be given fair and equal consideration, regardless of race, religion, color, gender, age, sexual orientation, disability, veteran status, or national origin, except that minimum age limits imposed by law are to be observed. If selected for employment, a prospective employee must provide satisfactory references for the City and meet our applicable pre-employment qualifications.
Applicants requiring disability-related accommodations for interviews should request them in advance. Individuals with disabilities should request reasonable accommodations in accordance with the Americans with Disabilities Act.
Are you a United States citizen?*
1. Yes
2. No
In accordance with Missouri House Bill 1549, the City of Republic will use the e-Verify process to confirm the identity and employment eligibility of each employee hired after January 1, 2009.
Date:*
Date:
Position Applied For:*
Date Available for Employment:*
Date Available for Employment:
Where did you hear about the position:*
Last Name:*
First Name:*
Middle Name:
Other last name(s) used:
Address:*
City:*
State:*
Zip Code:*
County:*
Email Address
Home Phone:*
Work Phone:
Continue

Veteran's Information

Have you ever served on active duty (exclude training as a reservist or guardsman) in the U.S. military service?
1. Yes
1. No
Branch:
Dates of Service:
Dates of Service: Start Date
—
Dates of Service: End Date
Continue |Go Back

License or Registration

Employment History

Additional Information

Education

Specialized Training & Skills

References

LIST BELOW THREE UNRELATED REFERENCES, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.
Name:*
Years Known:*
Address:*
Position:*
Phone:*
Name:*
Years Known:*
Address:*
Position:*
Phone:*
Name:*
Years Known:*
Address:*
Position:*
Phone:*
ARE YOU RELATED TO ANY FULL-TIME EMPLOYEE CURRENTLY EMPLOYED BY THE CITY OF REPUBLIC?
1. Yes
1. No
If yes, please list the employee’s name, relationship to you, and department (if known).
Employee's Name:
Relationship to You:
Department:
Employee's Name:
Relationship to You:
Department:
Continue |Go Back

Interest

Name:*
Please state why you are interested in this position with the City of Republic and what steps you have taken to prepare yourself for this career choice. You are to complete the task solely on your own without assistance from anyone else.*
Continue |Go Back

Cover Letter/Resume Upload

Upload your cover letter (optional)
Upload your resume (optional)
Note: Uploading your cover letter and/or resume does not take the place of a completed job application. This application must be submitted to be considered for employment.
Continue |Go Back

Authorization

Please read the statements below carefully. Your signature indicates that you fully understand and agree to the provisions of each statement.
I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, regardless of when discovered by the City of Republic. Any information obtained through former employers and/or personal references will become property of the City of Republic and will be considered confidential. I understand all application materials and supplemental information submitted will not be returned to me or any requesting agency. I waive any claims for the right to review and/or copy any information obtained through investigation of my character and employment history. I release the City of Republic from any liability or damage caused by giving and receiving information or opinions as to my employment or character.
I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be “at will” and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the City of Republic. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the City of Republic unless made in writing.
If I am offered employment, I agree to submit to a drug test within two business days of notification and medical examination (if required) before beginning employment. If employed, I also agree to submit to a drug test or medical examination (if required) at any time deemed appropriate by the City of Republic and as permitted by law. I consent to such examinations and tests and I request that the examining doctor disclose to the City of Republic the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent permitted by the law, is contingent upon satisfactory medical examinations and drug test.
If hired, I agree to abide by all City of Republic work rules, policies and procedures. The City of Republic retains the right to revise its policies or procedures, in whole or in part, at any time.
If you are to be hired by the City of Republic, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. You cannot be hired if you are unable to comply with these requirements.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature
If the applicant is under 18 years of age, parental consent is required to conduct the pre-employment substance abuse test, random substance abuse testing during their employment and/or background investigation.

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
Submit | Go Back

Search Forms:

Employment Application

Steps

Contact Information

Veteran's Information

License or Registration

Employment History

Additional Information

Education

Specialized Training & Skills

References

Interest

Cover Letter/Resume Upload

Authorization

Contact Us

Helpful Links