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Step One

Graham County Employment Application
921 Thatcher Blvd. Safford, AZ 85546 * Phone (928) 428-3250 * Fax (928) 428-5951
Received by:
Date & Time Received:
Graham County is an Equal Opportunity Employer and adheres to the principles and practices outlined in applicable federal, state and local laws and regulations that prohibit discrimination in employment and hiring. It is the policy and practice of the County to recruit, select, hire, train, promote, demote, terminate, compensate and administer all employment practices without regard to race, color, national origin, religion, age, sex, sexual orientation or any other legally protected status, unrelated to the ability to perform job functions with or without reasonable accommodations (except where a bona fide occupational qualification exists). Furthermore, the County is committed to complying with the Americans with Disabilities Act. If applicant requests a reasonable accommodation for purposes of completing the job application process, the County reserves the right to require professional documentation to confirm the need for accommodation.
Instructions: Please read the job announcement carefully before completing the application. Applications are only accepted for positions currently open for recruitment. Complete each item accurately and specifically. If you are unable to recall specifically any item of information requested, so indicate. All information you provide is subject to verification. Resumes may be submitted but will NOT be accepted in lieu of a completed application. A separate application is required for each position that you are applying for. A completed application must be received by the Board of Supervisors office on or before 6:00 p.m. on the stated closing date in order to receive consideration. Applications will not be accepted after this time and date. If this is an open continuous position, applications will continue to be accepted. When a position needs to be filled, applications will be pulled and reviewed. Applicants will be notified.
First Name*
Last Name*
M.I
Address*
City*
State*
Zip Code*
Phone Number*
Alternate Phone
Date Available:*
Date Available:
Social Security Number*
1. I will provide my Social Security Number after submitting my application.
Please read the text in the yellow box below.
IMPORTANT! Social Security Number
You will need to provide a valid Social Security Number to our Human Resources Department as we are unable to collect this information over the Internet. Please contact HR at 928-428-3250 after submitting your online application. Thank you.
Email Address
Position applying for:*
Are you a citizen of the U.S.?*
1. Yes
2. No
If no, are you authorized to work in the U.S.?
1. Yes
2. No
If you are applying for a Deputy Sheriff position, are you at least 21 years of age?
1. Yes
2. No
Have you ever worked for Graham County?*
1. Yes
2. No
If so, when?
Do you have any relatives who are currently employed in the department for which you are applying for?*
1. Yes
2. No
If yes, please list name/Department:
Providing a yes response and comment on the traffic violations, criminal record or dishonorable discharge does not eliminate you from consideration.
Have you been convicted of a misdemeanor or felony within the last 10 years?*
1. Yes
2. No
If yes, please explain.
Have you been cited for any moving traffic violations within the last three (3) years?*
1. Yes
2. No
If yes, please explain.
IMPORTANT! Drivers License
If you are applying for a position within our Graham County Highway Department you will need to provide a valid Drivers License Number, the date expired, date issued and state issued to our Human Resources Department as we are unable to collect this information over the Internet. Please contact HR at 928-428-3250 after submitting your online application. Thank you.
Do you have a current valid Driver's License?*
1. Yes, I will provide my Driver's License number after submitting my application (Please read text in yellow box above).
2. No
Do you have a Commercial Driver's License (CDL)?*
1. Yes, I will provide my Driver's License number after submitting my application (Please read text in yellow box above).
2. No
If yes, what class?
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Step Two

EMPLOYMENT HISTORY
This section must be filled out completely; DO NOT INDICATE “SEE RESUME”. Begin with your present or last job and work back. Account for all time during the past ten (10) years, including self-employment and U.S. Military service. Incomplete descriptions may result in an automatic disqualification. Attach additional pages if necessary. MUST BE COMPLETED IN FULL.
May we contact your current employer?*
1. Yes
2. No
May we contact your previous employer?*
1. Yes
2. No
Employer*
Phone Number*
Supervisor*
Address*
City*
State*
Zip Code*
Job Title*
Dates of Employment*
Salary Starting*
Salary Ending*
Job Responsibilities*
Number of Staff Supervised*
Reason for Leaving*
Employer*
Phone Number*
Supervisor*
Address*
City*
State*
Zip Code*
Job Title*
Dates of Employment*
Salary Starting*
Salary Ending*
Job Responsibilities*
Number of Staff Supervised*
Reason for Leaving*
Employer
Phone Number
Supervisor
Address
City
State
Zip Code
Job Title
Dates of Employment
Salary Starting
Salary Ending
Job Responsibilities
Number of Staff Supervised
Reason for Leaving
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Step Three

REFERENCES FOR EMPLOYMENT
Please list three (3) references, not related to you, that are familiar with your work history and experience. MUST BE COMPLETED IN FULL.
Full Name of Reference*
Please list someone NOT related to you.
Phone Number of Reference*
Relationship/Years Known*
Email Address of Reference*
Mailing Address of Reference*
City*
State*
Zip Code*
Full Name of Reference*
Please list someone NOT related to you.
Phone Number of Reference*
Relationship/Years Known*
Email Address of Reference*
Mailing Address of Reference*
City*
State*
Zip Code*
Full Name of Reference*
Please list someone NOT related to you.
Phone Number of Reference*
Relationship/Years Known*
Email Address of Reference*
Mailing Address of Reference*
City*
State*
Zip Code*
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Step Four

EDUCATION
Please list required High School information. If you have a college degree, please include that information also. "Other" is open for any vocational or trade schools, certificate programs, online education, etc.
High School*
Address*
City*
State*
Zip Code*
Did you graduate?*
1. Yes
2. No
If not, do you have a GED?
1. Yes
2. No
Issued By:
College
Address
City
State
Zip Code
Did you graduate?
1. Yes
2. No
Degree
Other
Address
City
State
Zip Code
Did you graduate?
1. Yes
2. No
Degree
Please list any license, registration, certificate, et., which you have obtained, and currently hold, that is required for the job you are applying for:
Please list any foreign languages you can speak, read and/or write:
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Step Five

MILITARY SERVICE
Graham County provides employment preference points (A.R.S. § 38-492) for Veterans when a point system is used by the hiring department to evaluate the applicants. If a point system is used, employment preference points shall be added to the total interview score earned by the applicant, but only when a passing score is earned without the preference points. Please note a maximum of 10 preference points is available. In order to be given any preference points, you must provide the Human Resources Department with a copy of the documentation that supports the below information, before the closing date of the Job Announcement. This form itself is not considered documentation. Preference points are only applicable to initial employment and not to promotions, voluntary demotions or transfers.
Branch
Rank at Discharge
Type of Discharge
If other than honorable, explain:
Are you currently a member of the National Guard or Reserves?
1. Yes
2. No
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Step Six

Attach Resume (Optional)
PLEASE READ THE FOLLOWING BEFORE SIGNING:
DISCLAIMER
I hereby certify that all statements in this application are true, and I understand that any misstatements or omissions of facts may cause forfeiture of any employment that may be offered.
Electronic Signature*
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.
1. I agree.
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1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Graham County Employment Application

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