Employment Application Step 1 of 6 - Applicant Details 16% PLEASE READ CAREFULLY Submission of an application does not assure employment. Employment is at the discretion of the District Attorney and may be terminated at any time. All employees of the District Attorney may be asked to submit to fingerprinting by a local, state or federal agency. The personal background and work experience information requested in this application will aid in evaluating your potential for employment and proper job placement, so please complete the form as thoroughly as possible. Applicant DetailsApplicant Name(Required) First Middle Last Email Address Enter Email Confirm Email Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone(Required)Alt. PhoneSocial Security Number Do you have any relatives currently employed by the office of the District Attorney?(Required) Yes No If yes, please list name(s)(Required) Do you have the legal right to work in the United States?(Required) Yes No Are you currently holding any public office?(Required) Yes No If yes, please explain(Required) Are you more than 17 years of age?(Required) Yes No Type of Employment Sought Full Time Part Time Summer Position Sought Salary Requirement Date Available Education & SkillsHigh SchoolName of SchoolAddress of SchoolYears AttendedGrade AverageType of DegreeYear of Degree Add RemoveBusiness SchoolName of SchoolAddress of SchoolYears AttendedGrade AverageType of DegreeYear of Degree Add RemoveCollegeName of SchoolAddress of SchoolYears AttendedGrade AverageType of DegreeYear of Degree Add RemoveGraduateName of SchoolAddress of SchoolYears AttendedGrade AverageType of DegreeYear of Degree Add RemoveList Computer SkillsTyping Skills: Words Per Minute Employment HistoryAre you currently or have you ever been employed by Allegheny County?(Required) Yes No If yes, please provide(Required)Position TitleDepartmentDates of EmploymentReason for Leaving Add RemoveEmployment HistoryBeginning with PRESENT, or MOST RECENT, list all previous employers, including self-employment, summer and parttime positions. If necessary, use additional blank pages. If applying for attorney position, indicate non-legal work experience below. EmployerPhoneDates EmployedPositionSupervisorReason for LeavingDescription of Work PerformedFinal/Present Salary Add RemoveMay inquiry be made of your present or most recent employer regarding your character, qualifications and record of employment?(Required) Yes No If presently employed, why do you wish to change your position?If presently unemployed, what have you done since your last job?Have you ever been fired from any job or quit a job after being informed that you would be fired?(Required) Yes No If yes, please explainU.S. Miliary ServiceBranchPeriod of Service (Yrs. & Mos.)Highest Rank AttainedDate & Type of Discharge Add Remove ReferencesList two people who are not related to you and who are not former employers who have knowledge of your qualifications and to whom we can referList(Required)NameAddressPhoneOccupation Add Remove Criminal HistoryConviction of a criminal offense may not be a ban to employment, however, if the answer to any of the below is “yes”, you must provide details in the fields provided.Have you ever been convicted of a criminal offense (felony, misdemeanor, or summary)? Exclude summary traffic violations punishable by fine only.(Required) Yes No If yes, please explainDo you have any criminal charge(s) pending against you?(Required) Yes No If yes, please explainHave you ever forfeited bond or collateral in connection with a criminal charge?(Required) Yes No If yes, please explain Resume (optional)Upload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB.Authorization & Consent(Required)In filing this application, I hereby declare that my answers are true, and understand that misrepresentation or omission of the facts called for herein will be sufficient cause for dismissal. I hereby agree to take a physical and other examinations whenever required by the District Attorney’s Office, whether prior to or subsequent to employment. I hereby authorize the investigation by the District Attorney’s Office of any and all statements contained in this application. I further agree to accept and abide by all regulations, policies and practices of the office relating to its employees. I authorize and consent to the release of information and records to the Office of the District Attorney of Allegheny County by any person or entity not a consumer-reporting agency to assist the District Attorney’s Office in completing a background investigation relative to my application for employment. I understand that as a part of the District Attorney’s procedure for processing employment applications an investigation and a report may be made by a consumer reporting agency in the process of which information may be obtained through interviews with third parties, such as family members, business associates, financial sources, friends, neighbors, or others with whom I have been acquainted. This inquiry may include information as to my character, general reputation, personal characteristics, and mode of living, whichever may be applicable. I understand that under the Federal Fair Credit Reporting Act, I have the right to make a written request within a reasonable period of time for a complete and accurate disclosure by the District Attorney of the nature and scope of the investigation requested. If this application for employment is denied either wholly or partly because of information contained in a consumer report from a consumer reporting agency, I understand that the District Attorney’s Office shall so advise me and shall supply me with the name and address of the consumer reporting agency making the report. I authorize and consent to the terms aboveSignature
