Northern Arizona Council of Governments
119 East Aspen Avenue * Flagstaff, Arizona 86001
Job Line:  (928) 774-2233 * Fax:  (928) 779-6208 *  Main Line:  (928) 774-1895 * www.nacog.org
 

APPLICATION GUIDELINES

NACOG would like to thank you for your interest in our organization.  To ensure your application is processed accurately, please review the following information BEFORE filling out your application.  You may detach these guidelines and instructions for your records.
 

  • Applications are accepted for advertised positions ONLY.  (Exceptions:  Applications for monthly pool advertisements, which may be submitted at the Head Start Centers).

  • AN INDIVIDUAL APPLICATION IS REQUIRED FOR EACH POSITION YOU ARE APPLYING FOR.

  • Resumes are optional and CANNOT be substituted for the application.

  • Applications submitted in person MUST BE received on or before the designated closing date by 5:00 p.m. September to May or 4:00 p.m. June to August.
  •  Applications that are mailed and post marked on or before the closing date will be accepted.

  • Applications sent via fax must be received by the closing date and time designated above.

  • All applications MUST have the original signature of the applicant to be considered valid.  Xeroxed or faxed copies of the application are acceptable, HOWEVER, for faxed copies, you will be required to bring in or mail the application with your original signature.

  • Copies of certificates and awards may be included with the application as supporting documentation.  Please DO NOT send originals, as they will not be returned.

  • Please attach your college transcripts for professional/exempt level positions to expedite the review process.  (i.e. Head Start Teacher and Teacher Aide.)

  • Please fill out all information requested on the application.  "SEE RESUME" IS NOT ACCEPTABLE.  (Applications will be returned as incomplete!!)

  • PLEASE TYPE OR PRINT LEGIBLY.  Use blue or black ink ONLY!

  • BEFORE you sign your name, please read the "Conditions of Employment" disclosure on last page of the employment application.


 

 

 

 

 

 

 

NACOG
APPLICATION INSTRUCTIONS

INVITATION TO SELF IDENTIFY:  (OPTIONAL)

The information you provide is voluntary and in no way shall affect your application for employment.  The information is to be used for statistical and federal reporting purposes.  For those who wish to disclose the appropriate information please complete your name, date applied, position applying for, location (work site) and department.  Circle the response best suited for your response.
 

APPLICATION FOR EMPLOYMENT:   (MUST be completed in its entirely)
 
1.  Position Information
· Indicate the POSITION /CITY you are applying for (refer to advertisement, recruitment notice or job line). An application is required for each position so if you are applying for two positions you must submit two applications.
 
2.  Personal Information
· Last Name, First Name, (both MUST reflect the name as indicated on your Social Security Card) and Social Security Number.
· Mailing Address, City, State and Zip Code (required for notification of application status).
· Home Phone Number (if none listed, may delay notification process).
· Message Phone Number (optional).
· Alternate Contact Source (where applicable - please be specific and include most current information).
· United States Citizen Status (circle your response and provide supporting information where requested).
·  Other Pre-Employment Information (Circle your response and provide additional information where applicable).
 

3.  Educational Information
· High School (provide the name, city and state) and circle the highest grade completed.
· Post-Secondary Education (provide name, city and state of college/university/or other schools) including vocational or technical schools.
· Dates Attended, Credit Hours Completed, Type of Degree Earned (if acquired) and Curriculum (Major and Minor).
· List any course(s) or workshop(s) relevant to the position for which you are applying.

 
4.  Other Important Information
· Provide a list of computer software and/or hardware you are knowledgeable with and years of experience.
· List all pertinent professional organizations, affiliations, and/or honors.
· List additional information (including skills, experiences, education, background and interests) which may fully describe your qualifications to the position for which you are applying. 
 
5.  Employment History (MUST be completed. "See Resume" Is Not acceptable. Applications will be returned as incomplete)
· List all previous employers in chronological order, beginning with the most CURRENT.
· Provide the dates of employment from beginning to end by month and year (mm/yy or 01/99).
· Indicate the employer's name, address (city, state and zip code) and phone number (including area code).
· Provide the (official) position title, salary (starting and ending) and supervisor's name.
· List the essential functions (or summary) of the position duties and responsibilities (attach additional sheets if necessary).
· Indicate the reason for leaving (provide a brief and relevant statement).
 
6.  References
· List (3) three people other than relatives or supervisors who can attest to your character and ability regarding the position for which you are applying, (please include phone numbers for direct contact).

 

 

 

Northern Arizona Council of Governments
119 East Aspen Avenue * Flagstaff, AZ 86001
Job Line: (928) 774-2233 * Main Line: (928) 774-1895 * Fax:  (928) 779-6208 * www.nacog.org

AN EQUAL OPPORTUNITY EMPLOYER
 

INVITATION TO SELF IDENTIFY
The purpose of this data record is to comply with governmental record keeping, reporting and other legal requirements. Periodic reports are made for the government based on the information listed below. The completion of this data record is OPTIONAL. All data record are kept in a confidential file and are not a part of your Application for Employment or personnel file.
Last Name: First Name: Date:
Position:                                                                                              City:

*You may complete the following section by circling the appropriate lines below.

 I choose not to submit any of the personal information listed below.            

Gender

 Female                            Male
 
Race and Ethnic Identification 
Hispanic or Latino White Black or African American
Native Hawaiian or Other Pacific Islander Asian American Indian or Alaska Native
Two or More Races  
How did you come across this open position? 

NACOG Employee

Whom?
 

 NACOG Recruitment Notice
Newspaper

Specify:
 
NACOG Job Line
NACOG Website
Other Website

Specify:
 
Veteran Status
Vietnam Era Veteran Disabled Vietnam Era Veteran Veteran-Other
Disabled Veteran-Other Not Applicable  

 

 

 

APPLICATION FOR EMPLOYMENT

Northern Arizona Council of Governments
Human Resources
119 East Aspen Ave * Flagstaff, AZ 86001
Job Line (928) 774-2233 * Main Line (928)774-1895 *  Fax:  (928) 779-6208 * www.nacog.org

Position Information
Position:                                                                                                     City:

*A separate application is required for each position.

 

Personal Information
Legal Last Name: Legal First Name: Social Security #          -         -
Mailing Address: City, State: Zip Code:
Home Phone Number: (          ) Message Phone Number: (         )
If you do not have a phone, how may we contact you?

 

Are you a citizen of the United States?  If not, do you hold the legal right to be employed in the US? (Circle one)

Yes

No
If you are not a citizen, but have answered "Yes" above, please provide your Visa #:  
If hired, you will be required to submit proof of identity and eligibility to work in the US as required by the Immigration Reform and Control Act of 1986.
Have you ever been convicted of anything other than a minor traffic violation?
If yes, attach information including the offense, date and conviction.  A conviction will not automatically disqualify you from employment.  Each case will be assessed on the relevance of the conviction to a hiring decision.

Yes

No

 

Have you previously been employed by NACOG? If yes, when? Yes No
Do you have any relatives who are employed by NACOG or serve on a NACOG Board or Council?  If yes, provide name and relationship: Yes No
Are you a Head Start parent? Yes No
Have you ever been discharged from any employment or asked to resign? Yes No
If yes, please explain:
 
Are you applying for a job which requires a Driver's License?

Yes

No
If yes, please complete: License#: Class: State:
If you are hired or transferred into a position that requires the operation of a vehicle, we will require a DMV investigation.  Do you authorize investigation of your DMV record? Yes No
Do you authorize a background investigation including prior employers, education and criminal records? Yes No

Please complete entire application even if you attach a resume.
Incomplete applications will not be considered for employment.
 

 

Educational Information
Name and Location (City/State) of last high school:
Circle last grade completed in high school: 9 10 11 12 GED

Name and Location
(City/State) of College/ University/Other Schools

Dates Attended

       From                To

Number of
Credit Hours
Completed

Type of
Degree
Earned

Curriculum

                 Major                          Minor
             
             
             

List any courses or workshops you have attended that related to the job for which you are applying:


 

 

Other Important Information
List computer software and hardware you can use and years of experience:


 		 Word Processing:
 

WPM
List professional organizations, affiliations and/or honors:

 

Employment History
Please list all previous employers starting with your present or most recent position below
Employer Name:
 		 Position Title
Address, City, State Zip Code Supervisor's Name
 
Phone #: Dates of Employment
     From:                                     To:		 May we contact your Supervisor?
                    YES                       NO
Starting Salary Ending Salary Full Time Part Time  

Hours Per Week
Duties and Responsibilities:


 
Reason for Leaving:

 




 

Employment History Continued
Please list all previous employers starting with your present or most recent position below
Employer Name:
 		 Position Title
Address, City, State Zip Code Supervisor's Name
 
Phone #: Dates of Employment
     From:                                     To:		 May we contact your Supervisor?
                    YES                       NO
Starting Salary Ending Salary Full Time Part Time  

Hours Per Week
Duties and Responsibilities:


 
Reason for Leaving:
Employer Name:
 		 Position Title
Address, City, State Zip Code Supervisor's Name
 
Phone #: Dates of Employment
     From:                                     To:		 May we contact your Supervisor?
                    YES                       NO
Starting Salary Ending Salary Full Time Part Time  

Hours Per Week
Duties and Responsibilities:


 
Reason for Leaving:
Employer Name:
 		 Position Title
Address, City, State Zip Code Supervisor's Name
 
Phone #: Dates of Employment
     From:                                     To:		 May we contact your Supervisor?
                    YES                       NO
Starting Salary Ending Salary Full Time Part Time  

Hours Per Week
Duties and Responsibilities:


 
Reason for Leaving:
Employer Name:
 		 Position Title
Address, City, State Zip Code Supervisor's Name
 
Phone #: Dates of Employment
     From:                                     To:		 May we contact your Supervisor?
                    YES                       NO
Starting Salary Ending Salary Full Time Part Time  

Hours Per Week
Duties and Responsibilities:


 
Reason for Leaving:

If you need more space for Employment History, please photocopy this page.

 

 


 

Additional Information

Please list any additional information which may more fully describe your qualifications,
skills, experience, education, background and interests.
 
 
 
 
 
 
 
 
 
 

 

References

List 3 persons other than relatives or supervisors who can attest to your character and
ability regarding the position for which you are applying.
Name Title Address Phone Number
       
       
       

 

Conditions of Employment

Please read carefully before signing.
You must sign this statement to be considered for employment.

I certify that the information given herein is true and complete to the best of my knowledge.  I authorize investigation of all statements contained in this application for employment, as necessary, to arrive at an employment decision.  I understand that this application is not intended to be an employment contract.  I also understand that if I am employed by NACOG, my employment is "at will," and NACOG or I may terminate the employment relationship at any time, for any reason, with or without notice.  I further understand that no employee of NACOG has the authority to modify the understanding orally or in writing except with the permission of the Executive Director.  I further understand that employment is probationary for a period of 6 to 12 months and that successful completion of this period does not guarantee regular employment.  In the event of employment, I understand that false or misleading information given herein or during and interview may result in discharge.  I also understand that if employed, I am required to abide by all NACOG rules and regulations.
  

  Applicant's Signature______________________________

 

  

 Date_______________