Employment App Submission Portal

Employment Application Submission

To be considered for the Town of Lake Waccamaw employment, you must answer all questions (unless listed as optional) and complete all sections of this application form.

The Town of Lake Waccamaw employs only US citizens or foreign nationals who can provide proof of identity and work authorization within 3 working days of employment. Males subject to military selective service registration must certify compliance to be eligible for local government employment (G.S. 143b-421.1). See availability block.

When completing this application make sure you:

Complete the equal opportunity information section.
Apply for one vacancy per application.
If you are a RIF applicant with priority- please check the appropriate box.
Give complete information on your education and work history (“see resume” is not acceptable).
List separately each job held and your duties for each position when you worked for one employer

and held more than one position. Use a continuation sheet, PD 107-A, if needed.
As you describe your work history, make sure you highlight your competencies (knowledge, skills, abilities and work behaviors) which demonstrate your qualifications for the position for which you

are applying.
Provide only the last four digits of your social security number.
Check for accuracy, sign and date your application.

Thank you for your interest in employment with the Town of Lake Waccamaw. Lake Waccamaw hires the most qualified people available to serve its citizens. Although everyone who applies cannot be hired, each application will be given consideration based on its competitiveness compared to other applications received. PD 107 (REV Oct 2022)

EQUAL OPPORTUNITY INFORMATION

Local Government policy prohibits discrimination based on race, sex, color, creed, national origin, age, genetic information or disability. Sex, age or absence of disability is a bona fide occupational qualification in a small number of local government jobs. The information requested below will not affect you as an applicant and is not forwarded to the hiring manager. Its sole use will be to see how well our recruitment efforts are reaching all segments of the population. Answering the ethnicity question is optional. Birth month and day is required for correct input by our technicians of paper application content into our electronic application system.

Ethnicity:

Birthday

Gender:

Male

Female

Disability:

Yes, I have a disability (or previously had a disability)

No, I don't have a disability

I don't wish to answer

APPLICATION FOR EMPLOYMENT

First Name

Last Name

Last 4 Digits of SSN

Street Address

City

County/State

Postal / Zip code

Phone

AVAILABILITY

Do you now work for the State of NC?

Yes

Are you a layoff candidate with the State of NC eligible for RIF priority reemployment consideration as described by GS 126?

Yes

Notification Date

Are you related by blood, or marriage, to any person now working for the State?

Yes

If yes, give name, relationship to you and the agency where employed.

If subject to Military Selective Service registration, certify compliance by initialing here:

MILITARY SERVICE

Have you served honorably in the Armed Forces of the United States on active duty for reasons other than training?

Yes

Do you wish to declare a service-connected disability?

Yes

At the time of this application, are you the surviving spouse or dependent of a deceased veteran who died from service-related reason?

Yes

Do you wish to declare eligibility for veteran's preference as the spouse of a disabled veteran?

Yes

Give dates of your (or your spouse's qualifying active military service:

JOB APPLIED FOR

If you are not available for work right now, enter the earliest date you could begin work:

Will you accept work anywhere in NC?

Yes

If no, list below the counties in which you would be willing to work.

REFERRAL SOURCE

Please indicate your referral source:

If you were referred by NC Workforce Solutions, please indicate which local office:

EDUCATION

High School Attended (Name, Location, Dates Attended, Graduate? Yes or No)

College(s) or University(s) Attended (Name, Location, Dates Attended, Graduate? Yes or No, Type(s) of Degree(s) Received)

Graduate or Professional School Attended (Name, Location, Dates Attended, Graduate? Yes or No, Type(s) of Degree(s) Received)

Other Educational, Vocational, Trade School Attended (Name, Location, Dates Attended, Graduate? Yes or No, Type(s) of Degree(s)/Certification(s) Received)

Special training programs and seminars you have completed in the last five (5) years (list):

If the job applied for calls for specific courses, or certifications, indicate those received here:

Current professional status: (List fields of work for which you have been registered)

Other licenses and certifications, including Driver's License and State, if any (list, giving dates and sources of issuance):

WORK HISTORY

(include volunteer experience) As you describe your work history experiences, make sure to highlight your competencies which demonstrate your qualifications for the position for which you are applying.

1. Current or Previous Employer

Address

Job Title

Start Date

End Date/Present

Supervisor's Name

Supervisor's Phone Number

Supervisor's Email

Reason for Leaving

May we contact employer?

Yes

List major duties that demonstrate your competencies related to the position for which you are applying in order of their importance in the job:

2. Employer

Address

Job Title

Start Date

End Date/Present

Supervisor's Name

Supervisor's Phone Number

Supervisor's Email

Reason for Leaving

May we contact employer?

Yes

List major duties that demonstrate your competencies related to the position for which you are applying in order of their importance in the job:

3. Employer

Address

Job Title

Start Date

End Date/Present

Supervisor's Name

Supervisor's Phone Number

Supervisor's Email

Reason for Leaving

May we contact employer?

Yes

List major duties that demonstrate your competencies related to the position for which you are applying in order of their importance in the job:

COMPLETION

Link to CV/LinkedIn

Upload Resume, Cover Letter and/or Required Position Documentation

Upload File

I certify that I have given true, accurate and complete information on this form to the best of my knowledge. In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration and licensing boards, and others to furnish whatever detail is available concerning my qualifications. I authorize investigation of all statements made in this application and understand that false information or documentation, or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action or dismissal if I am employed, and (or) criminal action. I further understand that dismissal upon employment shall be mandatory if fraudulent disclosures are given to meet position qualifications (Authority: G.S. 126-30, G.S. 14-122.1.)

Your Signature

Thank you! We’ll be in touch.

Employment Application Submission

Town of Lake Waccamaw

205 Flemington Dr. P.O. Box 145 Lake Waccamaw, NC 28450

M-F 8am - 5pm | Closed Noon to 1pm

PH :: (910) 646 3700

FX :: (910) 646 3860

info@lakewaccamawnc.gov

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