DELAWARE COUNTY EMPLOYMENT APPLICATION
10 Court Street, Delaware, Ohio 43015
AN AFFIRMATIVE ACTION / EQUAL OPPORTUNITY EMPLOYER
All applicants tentatively selected for this position may be required to test for illegal drug use
prior to appointments. An applicant with a positive test shall not be offered employment.
POSTION APPLYING FOR: EXPECTED SALARY
Name Social Security No.
Home Phone ( ) Business Phone ( )
Do you have a High School Diploma or G.E.D. certificate?
If NO, indicated highest grade completed.
1 2 3 4 5 6 7 8 9 10 11 12
List below all course work, special training or seminars that you have taken that relate to the requirements of this
position. If your training resulted in a degree, you need only list the major and type of degree earned.
NAME AND ADDRESS OF SCHOOL,
VOCATIONAL SCHOOL OR COLLEGE
TITLE OF COURSES
TAKEN OR MAJOR
Did You Graduate?
ETC. (IF YOU ATTENDED
UNDER ANOTHER NAME,
or Certificate or Other
Credential, if required
for this Position
Please list below the specific course work areas relevant to the position for which you ar