Job Applications

Spencer Municipal Utilities does not discriminate in hiring or employment on the basis of race, color, religious creed, national origin, age, sex, ancestry, disability, or any other classification protected by federal, state or local laws.  No question on this form is intended to secure information to be used for such discrimination.  Successful applicants will be required to produce verification of meeting minimum age requirements and may be required to have a criminal background check completed before beginning employment.  While Spencer Municipal Utilities will give this application every consideration, in accepting it SMU makes no commitment of employment to the applicant.  Individuals hired by Spencer Municipal Utilities must first pass a post offer pre-employment drug test.  All employees are subject to post offer, post-accident, random reasonable suspicion, return to duty, and follow-up testing.  Since SMU is a public employer, we are required to inform you that SMU is subject to the 2008 Iowa Smokefree Air Act.



PERSONAL INFORMATION

Name (Last, First, Middle Initial)
Street Address
City, State, Zip Code
Home Phone Number Cell Phone Number Work Phone Number May we contact you at work?
Email Address Type Of Employment Desired Are you at least 18 years of age?
Child labor laws prohibit employment of individuals
under the age of 18 in certain occupations
Position Desired Salary Desired
Do you have any friends or relatives working at Spencer Municipal Utilities?
If yes, please give their name and relationship to you:
How did you learn about this position (online, newspaper, referral, etc.):
On what date would you be available for work? Are you eligible to work in the United States?
(If offered employment, you will be required to provide documentation to verify eligibility.)
Do you have a valid driver's license? If yes, please specify the type of license
License Number: State of Issue: Expiration Date:
If a valid Commercial Driver’s License (CDL) specify the class/endorsements:
Have you ever served in the United States Military?
If yes, please specify dates: to
      Leave blank if presently in the military
Rank Achieved: Schools/Training:

EDUCATION/SKILLS Please list all education beginning with most recent.

  Name & Location of School # of yrs. Complete Graduated Degree &/or Major
High School/GED
College
Graduate School
Trade School/Other
OFFICE/COMPUTER SKILLS (check any that apply)
Word Processing Presentation Software Transcription Database GIS
Desktop Publishing CAD Ten key by touch Spreadsheet SCADA
SKILLS/CERTIFICATIONS List technical or specialized skills/credentials relevant to this job, certifications, professional licenses and/or registrations held.

REFERENCES Provide the names of three persons not related to you whom you have known at least one year.

Name Address Business Years Acquainted

EMPLOYMENT HISTORY List your four most recent positions relevant to the position you are applying for.

Dates Employed (month/year) Position Title
From: To:
Salary Organization Name/Address
Start: Final:
I was paid:
Employment Type:
Hours worked per week:
May we contact your references Supervisor's Name/Title/Phone
Reason for leaving:
Please explain your reason for leaving
Duties:
Dates Employed (month/year) Position Title
From: To:
Salary Organization Name/Address
Start: Final:
I was paid:
Employment Type:
Hours worked per week:
May we contact your references Supervisor's Name/Title/Phone
Reason for leaving:
Please explain your reason for leaving
Duties:
Dates Employed (month/year) Position Title
From: To:
Salary Organization Name/Address
Start: Final:
I was paid:
Employment Type:
Hours worked per week:
May we contact your references Supervisor's Name/Title/Phone
Reason for leaving:
Please explain your reason for leaving
Duties:
Dates Employed (month/year) Position Title
From: To:
Salary Organization Name/Address
Start: Final:
I was paid:
Employment Type:
Hours worked per week:
May we contact your references Supervisor's Name/Title/Phone
Reason for leaving:
Please explain your reason for leaving
Duties:
Authorization – I acknowledge that I have read the SMU Code of Ethics, and I certify that the facts contained in this application are true and complete to the best of my knowledge. I also understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein. I further authorize all individuals, companies, schools, corporations, courts, law enforcement, and all state motor vehicle agencies to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise. I release all parties from all liability for any damage that may result from divulging or using information. I understand that if I am hired to work for SMU, I will be required to comply with the Immigration Reform and Control Act of 1986 by providing proper identification to prove U.S. Citizenship. I understand and agree that I must pass a post offer pre-employment drug test. SMU is a drug & alcohol free employer. All employees are subject to post offer, post accident, random, reasonable suspicion, return to duty, and follow up drug and alcohol testing. I understand that if I would be considered for employment, I may need to complete a form for a criminal background check. Check will be done by the Iowa Division of Criminal Investigation. I understand and agree that, if hired, my employment is for no definite period, and that the employment relationship is an “at will” relationship, and understand that my employment and compensation can be terminated with or without cause, and without notice, at any time, at the option of either SMU or myself.
Digital Signature:   Spam Check: What does 6+4=
(Note: This application will be active for 12 months)
Visa   MasterCard   Discover
If you, a SMU customer, feel that you have processed a payment in error, please contact our customer service at 712-580-5800 or email us to request a refund.