Mecklenburg County ABC Board - Employment Application

The Mecklenburg County ABC Board is an Equal Opportunity Employer. Applicants for Employment may be subject to drug testing according to Mecklenburg County ABC Board Policies. ABC Board employees may also be required to submit to drug testing. Please fill out completely. Please note that the inclusion of any unsolicited information that is not explicitly job related will result in automatic rejection of this application. All applications are active for 90 days only. Anyone selected for an interview will be required to complete a paper application before being interviewed. Instructions: Please gather your information such as Employment Experience, Education Experience and References prior to filling out this form. This form will validate your application and will provide guidance if any information is missing or entered incorrectly such as a date. All dates should be entered in MM/DD/YYYY format. Once the application is properly filled out and submitted, you will be taken to an acknowledgement screen and you will receive an e-mail also acknowledging your application submittal. This form is optimized for viewing in Internet Explorer 6.0 and above.

Desired Position:
FirstName:	MiddleName: LastName:
Address:
City:	State: ZipCode:
Phone Number:	E-mail Address:
Have you ever been employed by the Mecklenburg ABC Board or any other ABC Board? YesNo
If yes, give date: (MM/DD/YYYY)
Do you have any relatives who are presently employed here? YesNo
If yes, give name and relationship:
Are you legally eligible to work in the United States? YesNo
On what date would you be available for work? (MM/DD/YYYY)
Are you available	Full Time Part Time
What Days and Hours are you available to work? (Please be specific.)

Have you ever been convicted of a misdemeanor or a felony (other than a minor traffic violation)? YesNo
(Conviction of a D.W.I. normally will disqualify the applicant from employment.) (Being charged with a crime will not necessarily disqualify an applicant from employment)
If yes, please explain:

Are you at least 21 years of age? YesNo
Do you have reliable means of transportation to get to work? YesNo

Employment Experience
List in consecutive order, beginning with present or most recent employment.
1.	Employer:	Phone No.:
	Address:
	City:	State: Zip Code:
	Current Employer?:	YesNo
	Dates Employed:	From To
	Hourly Rate/Salary:	Starting Final
	JobTitle:	Supervisor:
	Reason For Leaving:


Is there any reason why we should not contact your present employer or any past employer? YesNo
If Yes, Explain:
Have you ever been dismissed or forced to resign for cause from a prior job? YesNo
If Yes, Explain:


Special Skills and Qualifications
Summarize any special skills and/or qualifications acquired from employment or other experience.

List any current licensure or certification that you hold.


Education
Elementary
School Name:
Highest Grade Completed:	4 5 6 7 8
High School
School Name:
Highest Grade Completed:	9 10 11 12
College/University
School Name:
Highest Grade Completed:	1 2 3 4
Graduate/Professional
School Name:
Highest Grade Completed:	1 2 3 4
Diploma/Degree:
Describe Course of Study:
Describe Specialized Training, Apprenticeship and Skills

Honors Received:


References
Give name, address and telephone number of three references who are not related to you and are not previous employers.
1.	Name:	Phone No.:
	Address:
	City:	State: ZipCode:

2.	Name:	Phone No.:
	Address:
	City:	State: ZipCode:

3.	Name:	Phone No.:
	Address:
	City:	State: ZipCode:

Statement Of Applicant

I understand in applying for employment with the Mecklenburg County ABC Board that the completion of this application does not indicate there are any positions open and does not in any way obligate me or the ABC Board to an employment relationship. My application will remain active for no longer than three months from the date submitted. If I still desire to be considered for employment after that date, I understand I must file a new application.

The information given in this application is true in all respects. If any information is found to be false, I understand that I will either be refused employment or be subject to immediate dismissal if already employed. I authorize the ABC Board to investigate all information contained in this application. I authorize my present and former employers to release any information pertaining to my work record and performance, and release those employers from liability unless such information is provided with knowledge that is false.

I understand that a background investigative report may be made by a consumer reporting agency, and that if such a report is requested, I have the right under federal law to request in writing, within a reasonable time, detailed information about the nature and scope of the report. I also understand that the ABC Board may also investigate information contained in the public record. I understand that the ABC Board reserves the right to require applicants and employees to submit to testing for the presence of illegal drugs and alcohol. Refusal to submit to a requested test will result in non-consideration for employment or dismissal.

Finally, I understand that if employed, my employment with the ABC Board will be for no definite period of time, and that my employment may be terminated at any time by the ABC Board or myself without cause or notice. I understand that any contract for employment upon any other terms must be in writing and signed by the chairman of the ABC Board.

I understand and agree to the terms listed under "Statement Of Applicant"