The Muncie Sanitary District, Indiana, does not discriminate on the basis of race, color, gender, sexual orientation, gender identity, national origin, age, religion, or disability, in employment or the provision of services
EMPLOYMENT HISTORY AND WORK EXPERIENCE
List all employment history and work experience during the previous five years, beginning with your
current employer. Failure to include all past employment may be grounds for disqualification.
List and explain periods of unemployment in the past five years:
EDUCATION AND TRAINING
This section is intended to give the employer information about education and training you have
completed, and to describe your skills, knowledge and abilities to perform the duties of the position.
College(s) or Trade Schools(s)
MILITARY HISTORY AND STATUS
PROFESSIONAL OR SPECIALIZED TRAINING
Professional/special license(s) or certificate(s)
List current or previous affiliations/organizations and related offices/positions. (You may exclude
any which indicate race, color, religion, gender, sexual orientation, gender identity, age national
origin, or disability.)
List three references who are not related to you and are not former employers or supervisors who we are authorized to contact:
Read each of the following paragraphs carefully. Indicate your understanding of, and consent to, the contents and conditions of each paragraph by signing your initial at the end of each paragraph. If you have any questions regarding these paragraphs, contact the employer before initialing.
By submitting this document, I hereby agree that I shall execute the employer’s conditional and postemployment medical examination and drug testing consent requirements. I recognize that my future
employment with the employer will be jeopardized if I engage in substance abuse, illegal drug use, or alcohol abuse.