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Health District Job Application

An Equal Opportunity Employer
We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, sexual orientation, marital status, genetic information, or any other status protected by law or regulation. It is our intention that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors. Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.
Please let us know how you heard about this job opportunity. If you were referred by a current Health District employee, please include their name.
Please provide your full legal name in the following format: (First Name, Middle Initial, Last Name (if applicable)).
Do you have a maiden name or an alias you have used previously that we should be aware of?
Do you have another name you prefer us to use?
Please select the pronouns you prefer to be referred to by. Multiple choices allowed.
Please provide your current address in the following format: Street Address, City, State, ZIP Code
Please provide a phone number that you can be contacted at. If you cannot provide a phone number or would prefer not to be contacted by phone, please provide an email address in the next section. The Health District needs at least one way to contact you should we wish to schedule an interview with you.
Please provide an email address that you can be contacted at. If you cannot provide an email address or would prefer not to be contacted via email, please make sure that you have provided a phone number in the previous section. The Health District needs at least one way to contact you should we wish to schedule an interview with you.
Have you applied for a job with the Health District of Northern Larimer County before? If so, when did you apply?
If you have previously held a job with the Health District of Northern Larimer County, please let us know when you worked with us.
If you mark 'Yes,' please provide details in the next section. NOTE: A conviction will not necessarily disqualify an applicant for employment.
If you have not been convicted of any law violations, please write "N/A" or "Not applicable." NOTE: A conviction will not necessarily disqualify an applicant for employment.
Please provide a short description of the additional business you expect to be engaged in if employed by the Health District that includes an estimate of the amount of time devoted to each.
Education
In the section below, please list all relevant education applicable to each category. Compose each entry in the following format: School Name | Diploma, Degree, or Certificate Received | Name of Study or Field of Degree
If you earned a GED in lieu of a high school diploma, just enter "GED."
Please enter "N/A" or "Not applicable" if you have no college education. If you are currently enrolled in a program, include your anticipated graduation date next to your Name of Study/Field of Degree.
Please enter "N/A" or "Not applicable" if you have no vocational or technical education. If you are currently enrolled in a program, include your anticipated graduation date next to your Name of Study/Field of Degree.
Special Skills
Work History
List names of employers in consecutive order with present or last employer listed first. Account for all periods of time, including military service and any periods of unemployment. If self-employed, give the firm name and provide business references. NOTE: A job offer may be contingent upon acceptable references from current and former employers.
Please provide a brief description of your duties and responsibilities in this role.
Please provide a brief description of your duties and responsibilities in this role.
Please provide a brief description of your duties and responsibilities in this role.
Please provide a brief description of your duties and responsibilities in this role.
Please provide a brief description of your duties and responsibilities in this role.
References
Please provide 4 professional references (including past supervisors).
Please provide your reference's current title and the organization they work for.
Please provide your reference's current title and the organization they work for.
Please provide your reference's current title and the organization they work for.
Please provide your reference's current title and the organization they work for.