Skip to Main Content
menu
Get App
Submit a Crime Tip
Blog
Board Portal
Calendar
Child Support Offenders
Cold Cases
Crash Log
Crime Map
Employment
E Newsletter
FAQ
Forms
History of the Sheriff's Office
Hot Cases
Inmate Roster
Inmate Roster Grouped
Locations
Media Gallery
Message From The Sheriff
Most Wanted
Payment Standards Map
Pet Of The Week
Press Releases
Press Releases No Categories
Report Issues in Your Community
Services
Sex Offenders
Warrants
Contact Us
Contact Form Multi Location
Contact Form Embed Map
Back
Services
Employment Opportunities
All Modules
Chris Test #2
Testing
Testing 3
Aviation
Captains Corner
Big Table Test
Test
Back
Big Table Test
Chris Test #1
menu
menu
Emergency 911
Non-Emergency
800.506.8064
Submit Crime Tip
Receive Notifications
Pet Of The Week
Emergency 911
Non-Emergency
800.506.8064
Home
|
Contact
Submit Crime Tip
Receive Notifications
Pet Of The Week
Emergency 911
•
Non-Emergency
800.506.8064
CCSD - Employment Application
*
Required Fields
Print Form Before Submission
[{"type":"header","subtype":"h4","label":"PERSONAL INFORMATION","className":"d-block"},{"type":"text","required":true,"label":"Full Name","placeholder":"First, Middle, Last and Suffix","name":"Full-Name","className":"col-md-6","subtype":"text"},{"type":"date","required":true,"label":"DOB","name":"DOB","className":"col-md-6"},{"type":"text","required":true,"label":"Physical Address","placeholder":"Street Address, Apt/Suite","name":"Physical-Address","className":"d-block","subtype":"text"},{"type":"text","required":true,"label":"City","placeholder":"City","name":"Applicant-City","className":"col-lg-4","subtype":"text"},{"type":"select","required":true,"label":"State","name":"Applicant-State","className":"col-lg-4","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR","selected":true},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","required":true,"label":"Zip Code","placeholder":"Zip Code","name":"Applicant-Zip-Code","className":"col-lg-4","subtype":"text"},{"type":"text","label":"Mailing Address, if different from Physical Address","placeholder":"Mailing Address, Apt/Suite","name":"Mailing-Address","className":"d-block","subtype":"text"},{"type":"text","label":"Mailing Address City","placeholder":"City","name":"City","className":"col-lg-4","subtype":"text"},{"type":"select","label":"Mailing Address State","name":"Application-Mailing-State","className":"col-lg-4","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR","selected":true},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","label":"Mailing Address Zip Code","placeholder":"Zip Code","name":"Applicant-Mailing-Zip-Code","className":"col-lg-4","subtype":"text"},{"type":"text","subtype":"email","required":true,"label":"Email","name":"email","className":"col-md-6"},{"type":"text","subtype":"email","required":true,"label":"Email Confirmation","name":"email-confirmed","className":"col-md-6"},{"type":"text","subtype":"tel","required":true,"label":"Applicant Phone Number","placeholder":"(xxx) xxx-xxxx","name":"Applicant-Phone-Number","className":"col-md-6"},{"type":"text","required":true,"label":"Social Security Number","placeholder":"xxx-xx-xxxx","name":"Social-Security-Number","className":"col-md-6","subtype":"text"},{"type":"select","required":true,"label":"DL State","name":"DL-State","className":"col-md-6 col-lg-3","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR","selected":true},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","required":true,"label":"DL Number","name":"DL-Number","className":"col-md-6","subtype":"text"},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"text","required":true,"label":"Spouse's Name (if not married, Type N/A)","placeholder":"Spouse's Name","name":"Spouses-Name","className":"col-md-6","subtype":"text"},{"type":"text","label":"Spouse's Phone Number","placeholder":"xxx-xxx-xxxx","name":"Spouses-Phone-Number","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Father's Name","name":"Fathers-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Mother's Name","name":"Mothers-Name","className":"col-md-6","subtype":"text"},{"type":"date","required":true,"label":"Date Available","name":"Date-Available","className":"col-lg-4"},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"header","subtype":"h2","label":"Scheduled Hours","className":"d-block"},{"type":"paragraph","subtype":"p","label":"Employees in Patrol, Jail, Court/Transports, and Other are regularly required to work shifts that include nights, weekends, holidays, off-hours, and are subject to being on-call. This is vital to us to be able to provide 24-hour service to Cleburne County. By checking the box below, applicants for those positions are stating they understand the position they are applying for may require them to work those hours.
Admin/Records employees typically work Monday through Friday 8:30am-4:30pm in accordance with County Policy.
","className":"d-block"},{"type":"checkbox-group","required":true,"label":"Position Applied For","name":"Position-Applied-For","other":true,"className":"col-lg-4","values":[{"label":"Patrol","value":"Patrol"},{"label":"Jail","value":"Jail"},{"label":"Admin/Records","value":"Admin/Records"},{"label":"Court/Transport","value":"Court/Transport"}]},{"type":"checkbox-group","required":true,"label":"Hours Confirmation","name":"Hours-Confirmation","other":true,"className":"col-lg-4","values":[{"label":"Yes, I understand the hours","value":"Yes, I understand the hours"}]},{"type":"checkbox-group","required":true,"label":"Employment Desired","name":"Employment-Desired","className":"col-lg-4","values":[{"label":"Full-time","value":"Full-time"},{"label":"Part-time","value":"Part-time"},{"label":"Reserve","value":"Reserve"}]},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"header","subtype":"h4","label":"SOCIAL MEDIA ACCOUNTS: List all Social Media Account Handles (Do Not Provide Passwords)","className":"d-block"},{"type":"text","label":"Facebook","placeholder":"Facebook","name":"Facebook","className":"col-md-6","subtype":"text"},{"type":"text","label":"Twitter","placeholder":"Twitter","name":"Twitter","className":"col-md-6","subtype":"text"},{"type":"text","label":"Snap Chat","placeholder":"Snap Chat","name":"Snap-Chat","className":"col-md-6","subtype":"text"},{"type":"text","label":"Instagram","placeholder":"Instagram","name":"Instagram","className":"col-md-6","subtype":"text"},{"type":"text","label":"Other Social Media Account","placeholder":"Other Social Media Account Handle","name":"1st-Other-Social-Media-Account","className":"col-md-6","subtype":"text"},{"type":"text","label":"Other Social Media Account #2","placeholder":"Other Social Media Account Handle","name":"2nd-Other-Social-Media-Account","className":"col-md-6","subtype":"text"},{"type":"header","subtype":"h4","label":"EMPLOYMENT ELIGIBILITY","className":"d-block"},{"type":"radio-group","required":true,"label":"Are you legally eligible to work in the U.S.?","name":"Are-you-legally-eligible-to-work-in-the-US","className":"col-md-6 col-lg-3","values":[{"label":"Yes","value":"Yes legally eligible to work in US"},{"label":"No","value":"No, not legally eligible to work in US"}]},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"radio-group","required":true,"label":"Have you ever been convicted of a misdemeanor?","name":"Have-you-ever-been-convicted-of-a-misdemeanor","className":"d-block","values":[{"label":"Yes","value":"Yes, been convicted of a misdemeanor"},{"label":"No","value":"No, not been convicted of a misdemeanor"}]},{"type":"textarea","label":"If yes, please explain. Include year of conviction","name":"misdemeanor-If-yes-please-explain","subtype":"textarea","maxlength":1000,"rows":7,"className":"d-block"},{"type":"radio-group","required":true,"label":"Have you ever been convicted of a felony?","name":"Have-you-ever-been-convicted-of-a-felony","className":"d-block","values":[{"label":"Yes","value":"Yes, been convicted of a felony"},{"label":"No","value":"No, not been convicted of a felony"}]},{"type":"textarea","label":"If yes, please explain. Include year of felony conviction","name":"felony-If-yes-please-explain-Include-year-of-conviction","subtype":"textarea","maxlength":1000,"rows":7,"className":"d-block"},{"type":"header","subtype":"h4","label":"EDUCATION","className":"d-block"},{"type":"text","required":true,"label":"High School ","placeholder":"School name","name":"High-School","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"High School City","placeholder":"City","name":"High-School-City","className":"col-lg-4","subtype":"text"},{"type":"select","required":true,"label":"High School State","name":"High-School-State","className":"col-lg-4","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR","selected":true},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"date","required":true,"label":"Attended High School From","name":"Attended-high-school-Date-From","className":"col-lg-4"},{"type":"date","required":true,"label":"Attended High School To","name":"Attended-high-school-Date-To","className":"col-lg-4"},{"type":"radio-group","required":true,"label":"High School Diploma?","name":"High-School-Diploma","className":"col-lg-4","values":[{"label":"Yes","value":"Yes has high school diploma"},{"label":"No","value":"No does not have high school diploma"},{"label":"GED","value":"Has GED"}]},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"text","label":"College","placeholder":"School name","name":"College","className":"col-lg-4","subtype":"text"},{"type":"text","label":"College City","placeholder":"City","name":"College-City","className":"col-lg-4","subtype":"text"},{"type":"select","label":"College State","name":"College-State","className":"col-lg-4","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR","selected":true},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"date","label":"Attended College From","name":"College-Attended-Date-From-","className":"col-lg-4"},{"type":"date","label":"Attended College To","name":"College-Attended-Date-To","className":"col-lg-4"},{"type":"checkbox-group","label":"College Degree?","name":"College-graduate","other":true,"className":"col-lg-4","values":[{"label":"Yes - List degree in the 'other' box","value":"Yes graduated college"},{"label":"No","value":"No did not graduate college"}]},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"text","label":"Other","placeholder":"Program/School name, City, State","name":"Other-schoolprogram","className":"d-block","subtype":"text"},{"type":"date","label":"Attended Program From","name":"Attended-Date-From","className":"col-lg-4"},{"type":"date","label":"Attended Program To","name":"Attended-Date-To","className":"col-lg-4"},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"text","label":"Degree/Certification Received","placeholder":"Degree/Certification Received","name":"DegreeCertification-Received","className":"d-block","subtype":"text"},{"type":"header","subtype":"h4","label":"PREVIOUS EMPLOYMENT ","className":"d-block"},{"type":"text","required":true,"label":"Employer #1","placeholder":"Company/Individual Name","name":"Employer-1-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Employer #1 Address","placeholder":"Address","name":"1st-Employer-Address","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Employer #1 City","placeholder":"City","name":"Employer-1-City","className":"col-lg-4","subtype":"text"},{"type":"select","required":true,"label":"Employer #1 State","name":"Employer-1-State","className":"col-lg-4","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR","selected":true},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","subtype":"tel","required":true,"label":"Employer #1 Phone Number","placeholder":"xxx-xxx-xxxx","name":"1st-Employer-Phone-Number","className":"col-lg-4"},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"text","required":true,"label":"Employer #1 Supervisor Name","placeholder":"Supervisor Name","name":"1st-Supervisor-Name","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Employer #1 Starting Pay","placeholder":"Starting Pay","name":"1st-Starting-Pay","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Employer #1 Ending Pay","placeholder":"Ending Pay","name":"1st-Ending-Pay","className":"col-lg-4","subtype":"text"},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"radio-group","required":true,"label":"Employer #1 Employment Type","name":"1st-Employment-Type","other":true,"className":"col-md-6","values":[{"label":"Full-time","value":"Full-time"},{"label":"Part-time","value":"Part-time"}]},{"type":"text","required":true,"label":"Employer #1 Job Title","placeholder":"Job Title","name":"1st-Job-Title","className":"col-md-6","subtype":"text"},{"type":"textarea","required":true,"label":"Employer #1 Duties/Responsibilities","name":"1st-employer-dutiesResponsibilities","subtype":"textarea","maxlength":500,"rows":5,"className":"d-block"},{"type":"date","required":true,"label":"Employer #1 Employed From","name":"1st-Employed-From","className":"col-md-6"},{"type":"date","required":true,"label":"Employer #1 Employed To","name":"1st-Employed-To","className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"textarea","required":true,"label":"Employer #1 Reason for leaving","name":"1st-employer-Reason-for-leaving","subtype":"textarea","maxlength":500,"rows":5,"className":"d-block"},{"type":"text","label":"Employer #2","placeholder":"Company/Individual Name","name":"Employer-2-Name","className":"col-md-6","subtype":"text"},{"type":"text","label":"Employer #2 Address","placeholder":"Address","name":"2nd-Employer-Address","className":"col-md-6","subtype":"text"},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"text","label":"Employer #2 City","placeholder":"City","name":"Employer-2-City","className":"col-lg-4","subtype":"text"},{"type":"select","label":"Employer #2 State","name":"Employer-2-State","className":"col-lg-4","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR","selected":true},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","subtype":"tel","label":"Employer #2 Phone Number","placeholder":"xxx-xxx-xxxx","name":"2nd-Phone-Number","className":"col-lg-4"},{"type":"text","label":"Employer #2 Supervisor Name","placeholder":"Supervisor Name","name":"2nd-Supervisor-Name","className":"col-lg-4","subtype":"text"},{"type":"text","label":"Employer #2 Starting Pay","placeholder":"Starting Pay","name":"2nd-starting-Pay","className":"col-lg-4","subtype":"text"},{"type":"text","label":"Employer #2 Ending Pay","placeholder":"Ending Pay","name":"2nd-Ending-Pay","className":"col-lg-4","subtype":"text"},{"type":"radio-group","label":"Employer #2 Employment Type","name":"2nd-Employment-Type","other":true,"className":"col-md-6","values":[{"label":"Full-time","value":"Full-time"},{"label":"Part-time","value":"Part-time"}]},{"type":"text","label":"Employer #2 Job Title","placeholder":"Job Title","name":"2nd-Job-Title","className":"col-md-6","subtype":"text"},{"type":"textarea","label":"Employer #2 Duties/Responsibilities","name":"2nd-DutiesResponsibilities","subtype":"textarea","maxlength":500,"rows":5,"className":"d-block"},{"type":"date","label":"Employer #2 Employed From","name":"2nd-Employed-From","className":"col-md-6"},{"type":"date","label":"Employer #2 Employed To","name":"2nd-Employed-To","className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"
","className":"d-block"},{"type":"textarea","label":"Employer #2 Reason for leaving","name":"2nd-Reason-for-leaving","subtype":"textarea","maxlength":500,"rows":5,"className":"d-block"},{"type":"header","subtype":"h4","label":"REFERENCES (must list at least one professional, one personal, no family members)","className":"d-block"},{"type":"text","required":true,"label":"Reference #1","placeholder":"First and Last Name","name":"Reference-1-Name","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"Reference #1 Phone Number","placeholder":"xxx-xxx-xxxx","name":"Reference-1-Phone-Number","className":"col-md-6"},{"type":"text","required":true,"label":"Reference #1 City, State","placeholder":"City, State","name":"1st-reference-city-and-State","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #1 Relationship","placeholder":"Personal/Professional/Other","name":"1st-reference-Relationship","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #2","placeholder":"First and Last Name","name":"Reference-2-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #2 Phone Number","placeholder":"xxx-xxx-xxxx","name":"2nd-reference-Phone-Number","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #2 City, State","placeholder":"City, State","name":"2nd-reference-city-and-State","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #2 Relationship","placeholder":"Personal/Professional/Other","name":"2nd-reference-Relationship","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #3 ","placeholder":"First and Last Name","name":"Reference-3-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #3 Phone Number","placeholder":"xxx-xxx-xxxx","name":"3rd-reference-Phone-Number","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #3 City, State","placeholder":"City, State","name":"3rd-reference-city-and-State","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Reference #3 Relationship","placeholder":"Personal/Professional/Other","name":"3rd-reference-Relationship","className":"col-md-6","subtype":"text"},{"type":"header","subtype":"h4","label":"MILITARY SERVICE","className":"d-block"},{"type":"radio-group","required":true,"label":"Are you a veteran?","name":"Are-you-a-veteran","className":"col-md-6","values":[{"label":"Yes","value":"Yes, served in the military"},{"label":"No","value":"No, didn't serve in the military"},{"label":"Still serving - Active Duty","value":"Still serving - Active Duty"},{"label":"Still serving - Part-time/Reserve","value":"Still serving - Part-time/Reserve"}]},{"type":"text","label":"Branch","placeholder":"Branch","name":"Branch","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Rank at Discharge","placeholder":"Rank at Discharge","name":"Rank-at-Discharge","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"date","label":"Served From","name":"Served-From","className":"col-md-6 col-lg-3"},{"type":"date","label":"Served To","name":"Served-To","className":"col-md-6 col-lg-3"},{"type":"text","label":"Type of Discharge","placeholder":"Type of Discharge","name":"Type-of-Discharge","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"textarea","label":"If discharge was not honorable, please explain","name":"Non-honorable-discharge-","subtype":"textarea","maxlength":1000,"rows":6,"className":"d-block"},{"type":"header","subtype":"h4","label":"DL PHOTO","className":"d-block"},{"type":"file","required":true,"label":"Upload a picture of the FRONT of your Driver's License (35 Mb max). Files can be PDF, JPG, JPEG format. To upload multiple files, please hold control while clicking on multiple files before clicking \"Open\".","name":"DL-photo","subtype":"file","multiple":true,"className":"d-block"},{"type":"header","subtype":"h4","label":"BACKGROUND CHECK CONSENT AND DISCLAIMER","className":"d-block"},{"type":"paragraph","subtype":"p","label":"By submitting this form, I hereby authorize the County to investigate all statements in this application and to secure any necessary information from all my employers, references, and academic institutions. I hereby release all of those employers, references, academic institutions, and the County from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with the County. Cleburne County offers employment to all eligible persons regardless of race, color, national origin, religion, gender, sexual orientation, age, disability, marital or veteran status, or any other legally protected status, and is an affirmative action/equal opportunity employer. I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated. In the event of my employment with the County, I will comply with all official policies of the County policy manual and or other communications distributed by the County and the department head.","className":"d-block"}]