Employment Application; Benton County Mosquito Control District

Employment Application /

Benton County Mosquito Control District

Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Benton County Mosquito Control District (BCMC).

Please note: You must be at least 18 years of age at time of employment.

Date of Application

mm-dd-yyyy

Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Email *

example@example.com

Primary Contact Number *

If your Primary Contact Number is cellular, please list the carrier. (We ask for your cell phone carrier so we can send texts from a computer.)

Cell Phone Carrier

If necessary, what is the best time to call and/or text you?

Time; please list AM or PM

Please mark any/all positions you are applying for. *

Control Operator (Field) Public Education Specialist Surveillance Technician (Lab) Control Operator; Storm Drain Applicator Administrative Assistant (Front Desk)

You may reference the Job Descriptions on our website, or by requesting a Job Description from Benton County Mosquito Control District.

Mosquito Control

Are you legally eligible for employment in this country? *

Yes No

Start Date; Availability

mm-dd-yyyy

Estimated End Date

mm-dd-yyyy

Standard workday and workweek information:

You are nor required, nor expected, to work the entire season. We ask for start and end dates so we can adjust our workforce if needed.
BCMC changes its daily start and finish times as the season progresses to try and limit the time spent out in the heat of the day. Start times may be 8:00 AM, 7:00 AM, or 6:00 AM. You will be notified in advance when these changes will be occurring.
Standard works days are 8 hours with a 30 minute lunch break.
The standard workweek is Monday through Friday, but overtime (evening and/or weekend) may be required.
The season can run from March to October. It is highly dependent upon weather and mosquito activity.
Extended periods of absence must be approved, in advance, by your Supervisor or a management position.

Are you able to meet the attendance requirements? *

Yes No I need more information

If you marked "I need more information" for the question above, please list what information you need or what information you believe we should know.

The following question is not designed to elicit information about an applicant’s disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.

Are you able to perform the essential functions of the job for which you are applying (with or without reasonable accommodation)? *

Yes No I need more information

If you selected "I need more information" from above, please indicate in the box below what additional information you require.

BCMC employment includes the operation of District owned vehicles. We require the following items for employment:

A valid driver’s license.
A Driver’s Abstract, going back at least 3 years (choose the "3-year noncommercial insurance abstract" option).*

*You do NOT have to submit a driver's abstract with your application, but if you are offered a position you will have to (1) submit a driver's abstract before you can begin employment and (2) you will need to have a driver's abstract that is free of any major infractions.

If you choose to wait to submit a driver's abstract, please acknowledge the requirements and expectations listed above by typing your initials in the following box. Thank you.

By typing my initials in this box, I acknowledge that should I be offered a position with Benton County Mosquito Control I will need to provide a driver's abstract going back at least 3 years that is free of any major infractions.

Initials

If you wish to submit your driver's abstract now, you can either scan and email this to us (email to admin@mosquitocontrol.org or mail/drop-off at BCMC, 4951 W. Van Giesen Street, West Richland, WA, 99353.

How do I get a driver's abstract in Washington state?

To order your WA driving record online, visit the Washington Department of Licensing website and provide:

You will be required to set up an account; if you do not already have one.
Your WA driver's license number.
Your Social Security number (SSN).
The type of driving record you need; choose "3-year noncommercial insurance abstract" to cover the last 3-years.
Payment: the fee is $13.

Washington Department of Licensing

Alternatively, you can get a Driver's Abstract at a Washington DMV physical location. To request your driving record in person, visit your local Washington DMV office with:

Your WA driver's license or another form of photo identification.
Payment: the fee is $13.

Upload for Driver's Abstract Only

Browse Files

Driver's Abstract

Driver's License Number

License Number

What state issued your license?

State Name

Issued Date

mm-dd-yyyy

Expiration Date

mm-dd-yyyy

Answering “Yes” to the following question does not constitute an automatic bar to employment.

Have you entered into an agreement with any former employer or other party (such as a non-competition agreement) that might, in any way, restrict your ability to work for BCMC?

Yes No

If you answered "Yes" above, please explain.

You may attach a resume if you like, but it is not required. Please note that the attachment of a resume does NOT take the place of filling out the information found in this online form. Thank you.

Optional: Resume Upload

Browse Files

A resume is not required

Summarize any special training, skills, licenses, and/or certifications that may assist you in performing the position for which you are applying.

Computer Skills: check all appropriate items.

Word Processing (e.g. Microsoft Word) Spreadsheet (e.g. Microsoft Excel) Database (e.g. Microsoft Access) Email Tablets Social Media

In the following questions please exclude information that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran/reserve National Guard or any other similarly protected status.

Is there any other job-related information you would like us to consider, special accomplishments, awards, publications, etc.?

Please provide your two most recent jobs. If you have only one or zero to list that is fine, but please note this at the end of the Employment History section.
You may submit a resume along with the online employement application, but it will not be counted as a substitute for the online application.
At the end of the Employment History section you will have a the option (not required not expected) to add in any additional job history information that you believe is of value.

Employer

Employment Start Date

mm-dd-yyyy

Employment End Date

mm-dd-yyyy

Employer Website or Contact Information

Immediate Supervisor's Name and Title

May we contact this employer?

Yes No

Your Job Title

Reason For Leaving

Describe Job Duties

What did you enjoy the most about the job?

What did you enjoy the least about the job?

Employer

Employment Start Date

mm-dd-yyyy

Employment End Date

mm-dd-yyyy

Employer Website or Contact Information

Immediate Supervisor's Name and Title

May we contact this employer?

Yes No

Your Job Title

Reason For Leaving

Describe Job Duties

What did you enjoy the most about the job?

What did you enjoy the least about the job?

End of Employment History. Is there any additional employment information you would like us to know? (Optional)

Starting with your most recent school attended, provide the following information for up to two schools.

School

Date of Completion

mm-dd-yyyy

School Website or Contact Information

Completed

GED High School Diploma 2-Year Degree 4-Year Degree Post-Graduate Degree Certification

School

Date of Completion

mm-dd-yyyy

School Website or Contact Information

Completed

GED High School Diploma 2-Year Degree 4-Year Degree Post-Graduate Degree Certification

List names and phone numbers of two references that are not related to you and are not previous supervisors. We prefer work related references but this is not a requirement.

Reference's Name

First Name Last Name

Title (if applicable)

Relationship To You

Reference's Phone Number

Years Known

Reference's Name

First Name Last Name

Title (if applicable)

Relationship To You

Reference's Phone Number

Years Known

I certify that all information I have provided in order to apply for and secure work for the Benton County Mosquito Control District (BCMC) is true, complete and correct.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its representatives, employees or agents, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that BCMC does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

This application will stay active for the current calendar year. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without prior notice, and the employer reserves the right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of BCMC is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the District Manager.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that the federal immigration laws require me to complete an I-9 Form in this regard.

BCMC does not tolerate unlawful discrimination in it employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment for any protected status under applicable federal, state, or local law. BCMC likewise does not tolerate harassment. Harassment of employees is strictly prohibited. BCMC takes all complaints of harassment seriously and complaints will be investigated.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient to cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer’s service, whenever it is discovered.

I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement. *

Type your initials here

DO NOT SIGN UNTIL YOU HAVE FILLED OUT THIS APPLICATION

AND READ THE ABOVE APPLICANT STATEMENT

Signature *

Clear

Date of Signature

mm-dd-yyyy

Enter the message as it's shown *

Resume (optional)

Skills and Qualification

Employment History

Educational Background

References

Applicant Statement