Departmental Intern

This supplemental questionnaire is designed to obtain additional information about your education, training and experience as its related to the position. Resumes will not be accepted in lieu of this form. The forms must be completed in its entirety. Incomplete applications will not be considered.

By submitting this supplemental application, the applicant agrees and understands that the City of Dixon or its agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record. The applicant certifies that this application was completed by the applicant and that all entries on it and information on it are true and complete to the best of applicant's knowledge.

2. Are you currently pursuing a Civil Engineering degree?

Yes

No

3. If you answered no to Question 2, please tell us which degree you are currently pursuing.

4. Why are you interested in working as Departmental Intern in the Engineering/Utilities Department for the City of Dixon?

5. Do you understand that you MUST submit a valid satisfactory driving record. Attach a DMV printout obtained from an official California DMV office or online at www.DMV.ca.gov. The online Driver Record is not an official document, but the City will accept either this or an official copy.

Yes

No

6. I hereby certify that my responses to this questionnaire are complete and true to the best of my knowledge. I agree and understand that any material omission from, or misstatement of facts contained herein, will cause me to be disqualified from consideration or dismissed from employment with the City of Dixon.

Yes

No