Employment Application - Lake Worth Drainage District

Application For Employment
LWDD is an equal opportunity at-will employer. Prospective employees will receive consideration without discrimination because of race, color, religion, gender, sexual orientation, national origin, disability, marital status or veteran status. LWDD is a Drug, Alcohol and Tobacco Free Workplace!
Today's Date
MM slash DD slash YYYY
Name
First Last
Mailing address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number
Enter the phone number best to contact you.
Email Address*
Enter the email address best to contact you.
How did you hear about this job opening? If an employee, who?
Have you ever worked for LWDD?
- No
- Yes
When did you work for LWDD?*
Are you applying for a currently advertised position?
- No
- Yes
What advertised postion are you applying for?*
What postion are you interested in?*
Minimum pay per hour required*
Available start date
MM slash DD slash YYYY
Are you retired from any State of Florida administered retirement plan?
- No
- Yes
Do you have a valid driver's license?*
- No
- Yes
What State is the driver's license issued?*
What is the driver's license number?*
What type of driver's license?*
Is it a Class E, CDL, etc.
Has your driver's license ever been revoked?*
- No
- Yes
Please provide dates and explain reason.*
Have you used tobacco products in the past 6 months?
Tobacco products means, but is not limited to, cigarettes, cigars, e-cigarettes (vaping) products, chewing tobacco, etc.
- No
- Yes
Are you related to a current LWDD employee?
Related means, but is not limited to, blood relation, marriage, adoption, etc.
- No
- Yes
Name of relation*
First Last
Describe the type of relationship*
Have you ever been forced to resign or been fired?
- No
- Yes
Provide reasons*
Have you been convicted of a felony?*
- No
- Yes
Provide dates and explain*
Did you serve in the U.S. Armed Forces?
- No
- Yes
Veteran Preference Form
Please request an application for a 10-Point Veteran Preference Form at 561-498-5363 Ext 5574 or mwheelihan@lwdd.net
Educational Background
Graduated High School or have a GED
- No
- Yes
Provide the high school name and location
Attended College or University
- No
- Yes
Provide College or Univerity name and location.
Provide degree or number of years completed.
Specialized training/education/skills
Includes, but is not limited to, formal training, educational classes, trade school, and skills aquired on the job.
- No
- Yes
Provide the training program or school name, certification and date of completion. If applicable, provide specifics about machine/heavy equipment training and experience.
Employment Experience 1
Provide the 3 most recent employment experiences including your current position.
Date of Employment
Job Title
Employer or Company Name
Phone Number
Employer or Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Salary
Provide per hour rate of pay currently or at the time of separation.
Supervisor's Name
Reason for leaving
Employment Experience 2 :
Date of Employment
Job Title
Employer or Company Name
Phone Number
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor's Name
Salary
Provide per hour rate of pay currently or at the time of separation.
Reason for leaving
Employment Experience 3
Date of Employment
Job Title
Employer or Company Name
Phone Number
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor's Name
Salary
Provide per hour rate of pay currently or at the time of separation.
Reason for leaving
Have you ever been forced to resign or been fired?
- No
- Yes
If yes, please explain.*
References 1
Provide 3 references not related to you who would know your character.
Name
First Last
Relationship
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Reference 2
Name
First Last
Relationship
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Reference 3
Name
First Last
Relationship
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Emergency Contact
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Relationship
Upload Resume or other documents
Drop files here or

Accepted file types: jpg, pdf, gif, png, Max. file size: 50 MB.
Certification & Signature Authorization
To the best of my knowledge, all statements and information I have provided in this application are true. I hereby authorize Lake Worth Drainage District to conduct background checks and verify this information to determine my capabilities for employment. I understand that any statements found not to be materially accurate may constitute grounds for my dismissal or may disqualify me from consideration for any positions. The omission of required or material information (such as prior jobs) may be considered as grounds for dismissal or disqualification. I authorize release of information for reference checks. In accordance with Public Records Law, Chapter 119, F.S., information provided on this application may be “inspected and examined by any person desiring to do so, at any time, under reasonable conditions, and under supervision by the custodian of the public record or his designee.” I understand that LWDD is a Drug-Free Working and if applying for a safety-sensitive position, I will be required to submit to a drug test prior to employment. Further, I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.
*
- I have read and agree to the statement above.

Disclaimer: Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact the Lake Worth Drainage District by phone at 561.498.5363 or in writing at 13081 S. Military Trail, Delray Beach, FL 33484.

Application For Employment

Veteran Preference Form

Educational Background

Employment Experience 1

Employment Experience 2 :

Employment Experience 3

References 1

Reference 2

Reference 3

Emergency Contact

Certification & Signature Authorization

Website Use Disclaimer

Contact the LWDD

Office Location

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