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Online Employment Application

Valley Communications is an Equal Opportunity Employer


General Information
Have you applied with us before and how did you hear about us?
Position Applied for:
Today's Date:
If Other, Please Specify:
Last Name:
First Name:
Street Address:
City:
State:
Zip Code:
Home Phone #:
Message Phone #:
Are you eligible to work in the U.S.:		Yes No
Do you have a valid drivers license:		Yes No
	If Yes: Expiration Date:
	License State:
	License #:
Email Address:
Education
Have you graduated from High School or passed the G.E.D. test:		Yes No
Name of School:
	Street Address:
	City:
	State:
	Zip Code:
Employment History
List your present or most recent place of employment.
	Employment Dates	From: To:
	Job Title:
	Employers Name:
	Phone #:
	Address:
	City:
	State:
	Zip Code:
	Primary Duties:
	Supervisors Name:
	Phone #:
	Hours Worked Each Week:
	Salary:
	Reason For Leaving or Considering Change:
Are you able to perform all essential functions of this position (job description) with or without reasonable accommodations?		Yes No With Accommodation
Please let us know if you require a reasonable accommodation in order to participate in the testing process.
Voluntary Statistical Information
The following is completely confidential and voluntary. You are not required to answer it as a part of your application. We would, however, appreciate your completion of the information below. This information is gathered for statistical purposes only. This portion of the application is removed before your application is reviewed.
Gender		Female Male Other Prefer not to answer
Race/Ethnicity		American Indian/Alaskan Native Asian or Pacific Islander African American Caucasian Hispanic Other Prefer not to answer
By pressing the submit button below you certify that there are no willful misrepresentations or falsifications of statements and answers to questions herein. You are aware that should an investigation disclose such misrepresentations for falsifications, you application will be rejected or termination may result.