Completion of this form is voluntary. The City of Maumelle is an Equal Opportunity/Affirmative
Action employer. The City considers all applicants for all positions without regard to race, age,
religion, national origin, color, creed, sex, veteran status, disability or any other legally protected
Submission of this information is voluntary and your refusal to provide it will not subject you to
any adverse treatment and will not affect your employment with the City of Maumelle. The
information obtained will be kept confidential and will not be part of your personnel file. The data
will only be used in accordance with the provisions of applicable laws, executive orders, and
regulations, including those that require the information to be summarized and reported to the
federal government for civil rights enforcement. When reported, data will not identify any specific
Race and ethnic designations as used by the Equal Employment Opportunity Commission do not
denote scientific definitions of anthropological origins. Definitions of the race and ethnicity
categories are as follows (check the category that best defines your race/ethnic designation):
Equal Employment Statement: The City of Maumelle considers all applicants for employment
without regard to race, age, religion, national origin, color, creed, sex, veteran status, disability or
handicap or any other legally protected status.
Please Note: When a position has been filled it will no longer appear on the City of Maumelle
website. Only applicants who are selected for an interview will receive personal notification when
the position has been filled.
Application Acceptance: The City of Maumelle only accepts applications for vacant positions.
You must identify the position(s) for which you are applying and the position(s) must be open at
the time of your application. Applications will remain active for ninety (90) days.
If applying for Part-Time Recreational Assistant at Senior Services, which shift(s) are you applying for?
Number and Street
(Proof of eligibility will be required upon employment)
(A CONVICTION RECORD WILL NOT NECESSARILY BE A BAR TO EMPLOYMENT.)
(include city, state, Year of Graduation, Degree of Diploma)
(Include type, state where issued, and expiration date)
(Include type, date issued, and expiration date)
(List any other skills relative to the job(s) for which you are applying)
List three (3) persons not related to you who have knowledge of your work qualifications and can serve as a reference for you.
Please list prior work experience, including military service, beginning with your most recent
employment. (Include all work experience even if you do not believe the experience to be related
to the position(s) for which you are applying.) If you wish to include a resume, you must still
complete the entire application. We need a minimum of ten (10) years of history, if you have worked ten (10) years or longer.
(if different from current name)
(Start date-End Date)
(Lowest and Highest)
(If different from current name)
If applying for 911 Dispatcher, you must complete and attach the "Willingness Screening" form to complete the application process. This form is attached to the job description.
This field is not part of the form submission.
* indicates a required field