2. Apply for Child Support Case Manager

6. Summary

   Title: Child Support Case Manager

   Department: Job and Family Services

   Location: 1500 Park Ave., Eaton, OH 45320

10. Name
11. Email Address
13. Address
15. City
16. State
17. Zip Code
19. Phone Number
20. Cell Number

24. Resume                                                         Cover Letter

26. Upload your resume (supported formats: Word, PDF, RTF, Text and HTML)

27. Upload your cover letter (supported formats: Word, PDF, RTF, Text and HTML)

31. Personal

    
    

    Some information requested in this section may be requested again at the time of interview.  Please be aware that we do not collect full Social Security Numbers or Dates of Birth on the on-line application.

33. Former Name
34. *SSN (last four digits)
36. *DOB (month and day only)
38. Applicant's Driver License
39. Expiration Date (of Driver License)
41. List other licenses or certificates
43. Are you a U.S. citizen?
    -- Select One --YesNo
44. Are you legally eligible for employment in the US?
    -- Select One --YesNo
46. Have you been previously employed by us?
47. If yes, when?
49. List any friends or relatives working for us
50. Are there any experiences, skills, or qualifications which you feel would especially fit you for work with our organization?

54. Education

56. Highest Education Level Completed
58. Did you graduate?
    -- Select One --YesNo
59. If no, was a GED received?
    -- Select One --YesNo
61. College or University name and address
63. Major
64. Credit hours earned
66. Graduation date
67. Degree or Certificate awarded
69. College or University name and address
71. Major
72. Credit hours earned
74. Graduation date
75. Degree or Certificate awarded
77. College or University name and address
79. Major
80. Credit hours earned
82. Graduation date
83. Degree or Certificate awarded

87. Experience

    Give your complete employment record, including relevant experience.  If you were empowered under another name, write in the name by which you were known to your employer.  Begin with your most recent employment.  If additional space is needed, describe your additional experience in your uploaded resume.  THIS SECTION MUST BE COMPLETED.  THE ATTACHMENT OF A RESUME IS NOT SUFFICIENT.

89. Position 1

91. Title of your present or most recent position
93. If your current name the name that you are/were employed under?
    -- Select One --YesNo
94. If not please give name known by here
96. Company Name
97. Phone
99. Street Address
100. City
102. State
103. Zip Code
105. From (month and year)
106. To (month and year)
108. Name and title of immediate supervisor
109. Are you employed by this company now?
     -- Select One --YesNo
111. Description of duties
113. Reason for leaving

115. Position 2

117. Title of your present or most recent position
119. If your current name the name that you are/were employed under?
     -- Select One --YesNo
120. If not please give name known by here
122. Company Name
123. Phone
125. Street Address
126. City
128. State
129. Zip Code
131. From (month and year)
132. To (month and year)
134. Name and title of immediate supervisor
135. Are you employed by this company now?
     -- Select One --YesNo
137. Description of duties
139. Reason for leaving

141. Position 3

143. Title of your present or most recent position
145. If your current name the name that you are/were employed under?
     -- Select One --YesNo
146. If not please give name known by here
148. Company Name
149. Phone
151. Street Address
152. City
154. State
155. Zip Code
157. From (month and year)
158. To (month and year)
160. Name and title of immediate supervisor
161. Are you employed by this company now?
     -- Select One --YesNo
163. Description of duties
165. Reason for leaving

169. Prior Service

171. Have you been previously employed by Preble County or a system that pays into OPERS?
     -- Select One --YesNo
173. If yes, with who?
175. From?
176. To?
178. Were you in the US Armed Forces?
     -- Select One --YesNo
179. If yes, which branch?
     -- Select One --Air ForceArmyCoast GuardMarinesNavySpace Force
181. From?
182. To?
184. Rank at discharge
185. Type of discharge
187. List duties in the service including special training

191. Additional Information Revised

     Compliance with the county's drug testing policy is a condition of employment.  Therefore, all job offers are made with the understanding that prospective employees pass a drug screening test prior to being hired.

193. Do you feel that you need to speak to a represenative about a disability that would effect your job?
     -- Select One --YesNo
194. Do you have any additional skills that relate to this position? If so please list below

196. Please Note: Title 35 of the Ohio Revised Code prohibits anyone convicted of a felony to serve as an election officer.

     Must be able to provide references upon request.

     APPLICATION WILL NOT BE ACCEPTED IF THIS AFFIRMATION IS OMITTED.  I affirm that the answers I have made to each and all of the questions in this application are complete and true to the best of my knowledge and belief, and that intentional deception herein may be considered as sufficient cause for disqualification or dismissal if employed.  I hereby wave all provisions of law forbidding my colleges or universities which I attended, or past employers, from disclosing any knowledge of information which they thereby acquired relevant to my employment, and I hereby consent that they disclose any knowledge or information to the Preble County Board of Commissioners.  I hereby also consent to the release of all my police records concerning any arrest with subsequent convictions for crimes.  I hereby also consent to the release of my driving record including all citations.  I release these records to the Preble County Board of Commissioners and wave any right to personal privacy I might have over the records.

     I hereby certify that I have given the Preble County Board of Commissioners permission to obtain a copy of any arrest or conviction record pertaining to me now in the files of the OHIO BUREAU OF CRIMINAL INDENTIFICATION AND INVESTIGATION.  I hereby release the OHIO BUREAU OF CRIMINAL INDENTIFICATION AND INVESTIGATION and all individuals connected therewith from all liability in connection with the dissemination of such arrest or conviction date.

     I am applying for employment with the Preble County.  I understand that if employed, I agree to conform to the Preble County Board of Commissioners' rules.  I also agree that I shall be subject to other conditions which the Preble County Board of Commissioners may adopt.

     Preble County is an Equal Opportunity Employer.  State and Federal Law prohibits discrimination in the employment on the basis of race, color, religion, national origin, ancestry, sex, sexual orientation/identification, age and disability.

     All County offices adhere to a Smoke Free Workplace Policy.

198. Signature of Applicant
199. Date
Leave This Blank:


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

     This field is not part of the form submission.

203. Submit Submit and Print

* indicates a required field