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2. Application Instructions:

   Please answer each question fully and accurately. No action will be taken on this application until you have answered all questions. 

   Resumes and cover letters are not substitutes for the information requested on this application but will be accepted as supplemental materials. 

4. Position applying for:*
   -- Select One --EMT / AEMTFirefighter (Volunteer)Police OfficerPatrol SergeantDispatcher/Telecommunicator
6. Classification*

   Please indicate the class of work for which you are seeking.

   1. Full-time

   1. Part-time

   1. Paid on-call (EMS Only)

   1. Volunteer (Firefighters Only)
10. Applicant Information
12. First & Last Name*
13. Email Address
15. Address*
17. City*
18. State*
19. Zip Code*
21. Phone Number*
22. Date available for work:
24. List Alias(es), nickname(s), or any other names you may have worked under
26. Are you legally eligible for employment in the United States?*
    -- Select One --YesNo

    (Proof of US Citizenship or immigration status required to eligible for hire)

28. Have you ever been convicted or a felony or misdemeanor?*
    -- Select One --YesNo
30. If yes, please explain:*
32. Have you ever been employed by the City of Vermillion? *
    -- Select One --YesNo
33. Have you ever applied here before?*
    -- Select One --YesNo
35. Dates and Position:*
36. Date and position:*
38. Are you related to any city employee or elected official?*
    -- Select One --YesNo
39. Name(s) and relationship*
41. Do you have a valid Driver's License?*
    -- Select One --YesNo
42. Do you have a valid Commercial Driver's License (CDL)?*
    -- Select One --YesNo
44. Are you willing to work overtime if required?*
    -- Select One --YesNo
45. Are you willing to work alternating shifts if required?*
    -- Select One --YesNo
47. May we contact you at work?*
    -- Select One --YesNo
48. Phone Number*
50. Have you ever been fired from a job or asked to resign?*
    -- Select One --YesNo
51. Please explain*
53. Do you wish to claim veterans' preference pursuant to SDCL 3-3-1 and SDCL 3-3-2?*
    -- Select One --YesNo
54. To receive veterans' preference you must meet the requirements of South Dakota state law, SDCL 33A-2-1, be a resident of South Dakota, and present your DD214 in either digital form here or a physical copy to the City Manager's Office
58. Skills & Qualifications
60. Typing Words Per Minute (WPM):
62. Describe your proficiency with computer hardware and software:
64. List any relevant certifications:
68. Education
70. Name and Location of High School:*
71. Did you graduate?*
    -- Select One --YesNo
73. Name and Location of College:
74. Years Attended:
76. Degree(s) Completed:
77. Other Subjects Studied:
79. Trade, Business, or Technical School:
80. Years Attended:
82. Post Secondary School:
83. Years Attended:
85. Degree(s) Completed:
86. Other Subjects Studied:
88. Subjects studied:
89. Did you graduate?
    -- Select One --YesNo
93. Employment History

    List current or most recent first, including military service assignments

95. Position(s) Held:*
96. Dates of Employment*
    Dates of Employment Start Date

    —

    Dates of Employment End Date
98. Company Name:*
99. Address:*
101. City:*
102. State:*
103. ZIP:*
104. Phone Number:*
106. Supervisor's Name:*
107. Supervisor's Title:*
109. Responsibilities:*
111. Starting Title and Salary:*
112. Ending or Current Title and Salary:*
114. Reason for Leaving:*
118. Position(s) Held:*
119. Dates of Employment*
     Dates of Employment Start Date

     —

     Dates of Employment End Date
121. Company Name:*
122. Address:*
124. City:*
125. State:*
126. ZIP:*
127. Phone Number:*
129. Supervisor's Name:*
130. Supervisor's Title:*
132. Responsibilities:*
134. Starting Title and Salary:*
135. Ending or Current Title and Salary:*
137. Reason for Leaving:*
141. Position(s) Held:
142. Dates of Employment
     Dates of Employment Start Date

     —

     Dates of Employment End Date
144. Company Name:
145. Address:
147. City:
148. State:
149. ZIP:
150. Phone Number:
152. Supervisor's Name:
153. Supervisor's Title:
155. Responsibilities:
157. Starting Title and Salary:
158. Ending or Current Title and Salary:
160. Reason for Leaving:
164. Are you applying for a position with the Vermillion Police Department or the Clay Area Emergency Services Communication Center?*
     -- Select One --YesNo
166. Are you at least 18 years of age?*
     -- Select One --YesNoN/A

     Applicants for 911 Dispatcher must be at least 18 years old

167. Are you at least 21 years of age?*
     -- Select One --YesNoN/A

     Applicants for Law Enforcement must be at least 21 years old

169. Are you a Certified Police Officer?*
     -- Select One --YesNoN/A
171. Have you ever had your Driver’s License, in any state, suspended or revoked?*
     -- Select One --YesNo
172. Please explain:*
174. Have you ever had your law enforcement certification suspended, revoked, or voluntarily surrendered?*
     -- Select One --YesNo
175. Please explain:*
177. Have you ever voluntarily surrendered any professional/occupational certification or have you had any license suspended or revoked?*
     -- Select One --YesNo
178. Please explain:*
180. Have you ever been arrested or detained by a law enforcement agency?*
     -- Select One --YesNo
181. Please explain:*
185. Personal Statement*

     Please summarize your interest in working for the City of Vermillion. Additionally, tell us about your special skills, abilities, accomplishments, or military service that most qualify you for the position for which you are applying.

189. References

     Please provide three school, work, or personal references not related to you

191. Name & Title
192. Email Address
193. Phone
194. Years Known
196. Name & Title
197. Email Address
198. Phone
199. Years Known
201. Name & Title
202. Email Address
203. Phone
204. Years Known
208. While your application is the primary tool used to evaluate your job qualifications, resumes, applicable certifications or other applications materials you may wish to provide will also be considered.
210. Supporting Documentation
211. Supporting Documentation
212. Supporting Documentation
216. Applicant Statement
218. Please Read and Sign Below

     I hereby certify that the information given by me is true and complete to the best of my knowledge and belief. I further authorize investigation of all statements I have made. Misrepresentations, falsification, or omission of facts called for in this application or in the interview process is cause for cancellation of this application or termination of employment.

220. I authorize the City of Vermillion, its officers, agents, and employees to conduct a background investigation (including criminal) prior to making a decision regarding employment. I release and hold harmless the City of Vermillion, its officers, agents, and employees, and the person providing the information from any liability related to the performance or result of this check.

222. I hereby understand and acknowledge that, unless otherwise defined by applicable law, initial and ongoing employment with the City of Vermillion is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge an employee at any time with or without cause. It is further understood that this relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing.

224. I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current or past employer, and organizations to provide relevant information that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

226. I understand that if I am extended a conditional offer of employment, it may be conditioned upon my successfully passing a complete pre-employment physical examination. I give my consent to any pre-employment or post-employment health screenings, physical limitations testing, examinations, and/or any other requirements of the City of Vermillion if a conditional offer of employment has been given. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. We advise you not to resign or change your current employment status until you are advised that you have successfully completed the health assessment. I understand that I may be required to successfully pass an alcohol and drug screening examination. I hereby consent to a pre and/or post-employment alcohol/drug screen as a condition of employment, if required.

228. Finally, I understand that this application does not constitute a contract or guarantee of employment, or if employed, does not bind either party to a specific period of employment.

230. Authorization for Reference Requests*

     I have applied with the City of Vermillion for employment and I desire that they be fully advised of my record with former employers and schools I have attended. I, therefore, give my permission and request that former employers and prior schools attended furnish any and all requested information and records to the City of Vermillion on their request for references in regard to the position for which I have applied. In addition, I hereby release all involved parties from any and all liability of damages for requesting or providing the reference information.

     1. I authorize.
232. 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.
234. Electronic Signature*

     The City of Vermillion provides equal opportunity for all residents, applicants, and employees as it pertains to the provision of services and employment opportunities in order to ensure that there will be no discrimination against any person on the basis of race, color, religion, sex, age, gender identity and expression, national origin, ancestry, political affiliation, or any other basis prohibited by state or federal law. The City of Vermillion is prepared to make reasonable accommodations for applicants with a disability. If called for an interview, please advise the person calling of any accommodations that you may need.

238. Applicant Survey (Voluntary)
240. How did you learn about this position?

     1. Department of Labor
     2. Other City Department
     3. Current City Employee
     4. City of Vermillion Website
     5. Other Website
     6. Newspaper
     7. Other (please specify)
241. Where did you learn about this job opportunity? *
Leave This Blank:


243. Submit

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