Email (required)
Position(s) Applied For (required)
Date of Application (required)
Last Name (required)
First Name (required)
Middle Name (required)
Street Address (required)
City (required)
State (required)
Zip (required)
Telephone Number Day (required)
Telephone Number Evening (required)
Cell Phone (required)
If you are under 18 Years of age, can you provide required proof of your eligibility to work? (required) Yes No
Have you ever filed an application with us before? (required) Yes No
If yes give date
Have you ever been employed with us before? (required) Yes No
If yes give date
Are you currently employed? (required) Yes No
May we contact your present employer? (required) Yes No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (required) Yes No
On what date would you be available for work? (required)
Are you currently available to work: (required) Yes No
Are you currently on “lay-off” status and subject to recall? (required) Yes No
If hired, would you have reliable means of transportation to and from work? (required) Yes No
Do you have any relatives or friends working for the East Contra Costa Irrigation District? (required) Yes No
If yes, state names and relationships:
High School Name, Location and Phone Number (required)
Years Completed (required)
Describe Course of Study (required)
Describe any specialized training, apprenticeship, skills and extra curricular activities (required)
Describe any honors you have received (required)
State any additional information you feel may be helpful to us in considering your application (required)
College / University Name, Location and Phone Number (required)
Years Completed (required)
Describe Course of Study (required)
Describe any specialized training, apprenticeship, skills and extra curricular activities (required)
Describe any honors you have received (required)
State any additional information you feel may be helpful to us in considering your application (required)
Trade School Name, Location and Phone Number (required)
Years Completed (required)
Describe Course of Study (required)
Describe any specialized training, apprenticeship, skills and extra curricular activities (required)
State any additional information you feel may be helpful to us in considering your application (required)
Indicate any languages, other than English, that you can speak, read and/or write. (required)
List professional, trade, business or civic activities and offices held. You may exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, or handicap or other protected status: (required)
Current/Prior Employer (required)
Dates Employed (required)
Worked Performed (required)
Address (required)
Telephone Number(s) (required)
Job Title (required)
Supervisor (required)
Reason for Leaving (required)
Prior Employer (required)
Dates Employed (required)
Worked Performed (required)
Address (required)
Telephone Number(s) (required)
Job Title (required)
Supervisor (required)
Reason for Leaving (required)
Prior Employer (required)
Dates Employed (required)
Worked Performed (required)
Address (required)
Telephone Number(s) (required)
Job Title (required)
Supervisor (required)
Reason for Leaving (required)
LICENSES, SPECIAL SKILLS AND QUALIFICATIONS (required)
Reference Name (required)
Address (required)
Telephone (required)
Reference Name (required)
Address (required)
Telephone (required)
Reference Name (required)
Address (required)
Telephone (required)
Do you have the physical and mental ability to perform the tasks on the attached job description, with or without accommodation? (required) Yes No
If accommodation is necessary, please describe below (required)
(Initial) I, the undersigned applicant, have personally completed this application. (required)
(Initial) I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. (required)
(Initial) I hereby authorize East Contra Costa Irrigation District, ECCID, to thoroughly investigate my references, work record, education and other matters related to my suitability for employment unless otherwise specified above. I further authorize the references I have listed to disclose to ECCID any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release ECCID, my former employers and all other persons, corporations, partnerships and association from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. (required)
(Initial) I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and ECCID. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or ECCID, and that no promises or representations contrary to the foregoing are binding on the District unless made in writing and signed by ECCID’s designated representative. (required)
(Initial) I understand that if offered employment, the offer may be contingent on passing a pre-employment alcohol and drug screen and a pre-employment physical. I voluntarily agree to submit to these procedures. (required)
(Initial) In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. (required)
(Initial) All East Contra Costa Irrigation District employees are considered disaster service workers who may be required to report for duty, or remain on duty, to address disaster service activities in the event of an emergency or disaster. I understand and will comply with California Government Code Section 3100-3109. (required)
Date (required)
Applicant's Full Name as Signature (required)
Upload Resume (required)
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