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  1. PERSONAL DATA
  2. EDUCATION AND TRAINING
  3. Did you graduate?*
  4. SKILLS
  5. Do you posses a valid Driver's License?*
  6. EMPLOYMENT HISTORY

    A brief description of duties for each position is required below.  Additional details may be provided by attaching a resume, if desired. Please provide your employment history beginning with your present or most recent employer and list all positions held including military, part-time, summer, volunteer work and any periods of unemployment. 

  7. May we contact the employers listed above?*
  8. CRIMINAL, TRAFFIC, AND/OR CIVIL COURT RECORD
  9. Have you ever been convicted of, pled guilty or pled nolo contendere (no contest) to a felony?*
  10. In the past five (5) years, have you ever been convicted of, pled guilty, or pled nolo contendere (no contest) to a misdemeanor?*
  11. Have you ever been an employee of Barnwell County Government?*
  12. Include Name/Title, Company Name, and Phone Number

  13. GENERAL INFORMATION
  14. In order to prevent a delay in the processing of your application, please be sure to sign and date this form and answer every question clearly and completely.

    Each applicant considered for employment in a County position must meet the minimum requirements established for that position.  This may include the successful completion of a verbal/written examination and a drug screen.

    In compliance with the Title VI of the Consumer Protection Act, this is to advise you that as part of our processing of employment applications, an inquiry may be made concerning an applicant's credit standing, general reputation, character, and personal characteristics. This information may be from previous employers, personal references, law enforcement agencies, and/or consumer reporting agencies. Upon an applicant's written request, additional information as to the nature and scope of any report will be provided.

  15. SIGNATURE AND CERTIFICATION

    I hereby affirm that the information provided on this application (and accompanying resume and/or documentation, if any) is true and complete to the best of my knowledge. I also understand that falsified information or significant omissions may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date. I further understand that this application becomes the property of Barnwell County Government and will not be returned.

    I authorize persons, schools, my current employer (if applicable), and previous employers and organizations named in this application (and accompanying resume and/or documentation, if any) to provide any relevant information that may be required to arrive at an employment decision.

    I understand that should I be offered a position, my employment can be terminated, with or without cause, at any time at the discretion of either the County of Barnwell or myself.

  16. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  17. We thank you for applying for employment with Barnwell County Government, an equal opportunity employer.
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  19. This field is not part of the form submission.