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Employment Application

Orange County Employment Application
County Administrator's Office
112 West Main Street
P. O. Box 111
Orange, VA 22960

Ph: (540) 672-3313
Fx: (540) 672-1679

Orange County is an Equal Opportunity/Affirmative Action employer. All qualified applicants will be considered without regard to race, gender, color, national origin, religion, age, veteran status, political affiliation, marital status, sexual orientation, genetics, or disability in employment or provision of services.
Instructions
Please type or print legibly. We only accept applications for positions which we are currently recruiting. Applications must be submitted to the County Administrator's Office by the position closing time and date, if advertised. Applications must be complete and signed. You are encouraged to attach a resume to your completed County application; however, a resume is not a substitute for this form. Cover letter is optional. You may request any needed reasonable accommodation to participate in the application process. Employment decisions shall be made in accordance with all applicable laws.
Note:
This application will NOT be accepted for Sheriff's Office positions. Please contact the Sheriff's Office at (540) 672-1200 for more information on their application process.
Select a current job opening*
Date
Date
When are you able to start?*
Desired Salary
First Name*
Last Name*
Address 1*
Address 2
City*
State*
Zip*
Telephone*
Email Address*
Continue

Education & Training

Education & Training
High School Name*
High School Location*
Degree / Diploma*
College / University Name
College / University Location
Degree / Diploma
Describe any trade school, specialized training, apprenticeship, skills, civic and/or extra-curricular activities, and graduate studies:
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Experience

Experience
List below your 3 previous employers beginning with the most recent.
Employed From:*
Employed To:*
Employer Name*
Address 1*
Address 2
City*
State*
Zip*
Hours per Week*
Beginning Pay
Ending Pay
Your Title*
Immediate Supervisor*
Telephone
Describe Your Duties*
Reason for Leaving*
May we ask this employer about you?*
1. Yes
1. No
Employed From:
Employed To:
Employer Name
Address 1
Address 2
City
State
Zip
Hours Per Week
Beginning Pay
Ending Pay
Your Title
Immediate Supervisor
Telephone
Describe Your Duties
Reason for Leaving
May we ask this employer about you?
1. Yes
1. No
Employed From:
Employed To:
Employer Name
Address 1
Address 2
City
State
Zip
Hours per Week
Beginning Pay
Ending Pay
Your Title
Immediate Supervisor
Telephone
Describe Your Duties
Reason for Leaving
May we ask this employer about you?
1. Yes
1. No
Continue |Go Back

References

References
List persons, other than relatives or former supervisors, who know your qualifications and/or your character.
Name*
Relationship*
Address 1*
Address 2
City*
State*
Zip*
Telephone*
Email*
Name*
Relationship*
Address 1*
Address 2
City*
State*
Zip*
Telephone*
Email*
Name*
Relationship*
Address 1*
Address 2
City*
State*
Zip*
Telephone*
Email*
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General Information

Attachments & Electronic Signature

You are encouraged to attach a resume.
Attach only a PDF or Word document.
If desired, please attach a cover letter.
Attach only a PDF or Word document.
Where did you hear about our position?
1. Orange County Website
2. Employee Referral
1. Job Board Posting
2. Other
Signature Required
I hereby certify that every statement I have made on this application is true and complete. I understand that any false information or omission may be grounds for not employing me or for dismissal. I understand that this employment application shall be considered for this recruitment only. If I wish to be considered for other positions, I shall submit a new application for every position for which I wish to apply. I understand that I may have to produce documentation verifying all information given here. I authorize you to contact my former employers, schools, and references. I release all employers, firms, schools, and individuals of all liability for release of the information. My signature authorizes drug screening, investigative reports, criminal record checks, and a post-offer physical examination, if required by the position. I understand that this employment application is not an employment contract and, if employed, my employment with Orange County is at-will and may be terminated at any time and for any reason, stated or unstated.
Electronic Signature*
By checking the box below, I am providing an electronic signature. If printing this application, please sign the bottom of the page before sending the application to our office.
1. Sign

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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