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 status. 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 individual.
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 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 or until the position is filled, whichever is longer.
Number and Street
(Proof of eligibility will be required upon employment)
(include city, state, year of graduation, and type of degree or 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 ten (10) years of work experience, including military or volunteer service and periods of unemployment, beginning with your most recent employment. Include all work experience even if unrelated to the position(s) for which you are applying. “See Resume” is NOT a valid entry. Please complete the entire application.
(if different from current name)
Be Specific
(Start date-End Date)
(Lowest to Highest)
(If different from current name)
(use same information as employer 1, 2 and 3)
By typing your name here, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this form.
Applicants for 911 Dispatcher, must complete the "Willingness Screening" form to complete the application. This form is made available at the top of the job description.
This field is not part of the form submission.
* indicates a required field