Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Employment Application

  1. CONTACT INFORMATION

  2. EDUCATION

  3. Did you graduate from High School?*

  4. Did you graduate from College?*

  5. Add additional education?*

  6. Add additional education?

  7. Add additional education?

  8. Add additional education?

  9. How did you hear about this job?*

  10. BACKGROUND

  11. Are you currently employed by the City of Chickasha, OK in any capacity (including part time or seasonal contract)?*

  12. Have you ever been employed by the City of Chickasha, OK?*

  13. Are you related to any City of Chickasha employee or any City of Chickasha Council Member?*

  14. Have you ever volunteered with the City of Chickasha?*

  15. Have you ever been convincted of any criminal offense, pleaded guilty or solo contenders, or been found guilty of a criminal offense, even though adjudication was withheld or sentence was suspended?*

  16. Are criminal charges currently pending against you? *

  17. Do you have a valid Oklahoma driver's license? *

  18. Are you over 18 years old? *

  19. Are you aware of the policy of the City of Chickasha regarding drugs and alcohol in the work place?*

  20. WORK EXPERIENCE

    List most recent employer first.

  21. I am currently employed here.

  22. We may contact employers listed unless you indicate those you do not wish for us to contact.

    May we contact this employer?

  23. We may contact employers listed unless you indicate those you do not wish for us to contact.

    May we contact this employer?

  24. MILITARY

  25. Have you ever served on active duty in the U.S. Armed Forces? *

  26. REFERENCES

    Please list two professional references other than family members.

  27. If you would like to attach a résumé, please click "browse" above and upload the document.

  28. If you would like to attach any additional documentation, please use the box above to upload the document.

  29. Digital signature

    Please type your name below and click submit. By typing your name and submitting, you are certifying that all information on this application is true. Submitting an application does not guarantee employment with the City of Chickasha. A City of Chickasha representative will follow up with next steps or to obtain additional information, if needed.

  30. Leave This Blank:

  31. This field is not part of the form submission.