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Police Officer – 

Please fill out the two forms below

We are excited about your next steps here at the City of Nyssa. If you are interested in applying for a job, please fill out the Applicant Release Info and also the Application below.

APPLICANT RELEASE OF INFO

As an applicant for a position with the City of Nyssa, I am requested to furnish information for use in determining my qualifications and suitability to fill the position. I understand that any or all information contained in my application for employment may be subject to verification or investigation by the City. I also understand that criminal history and driving records will be checked if, in the judgment of the City such are relevant to the position for which my application for employment is made.
For these purposes, I consent to the release of information concerning my qualifications, suitability, and moral character by employers, education institutions, law enforcement agencies, and other relevant individuals and agencies to any duly authorized agent of the City of Nyssa. Such release includes any personnel or investigative files maintained by former employers.
I further consent to allow a photocopy of this release form when presented by a duly authorized agent of the City of Nyssa to serve as valid release even though the photocopy does not contain an original writing of my signature.
I hereby release, discharge and exonerate the City of Nyssa, Oregon its agents and representatives, and any and all agencies, organizations or individuals, or representatives thereof so furnishing information, from any and all liability of every nature and kind arising out of the furnishing or inspection of such documents, records, and other information pursuant to the Release of Information.
This release will expire one year after the date it is signed.
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This field is for validation purposes and should be left unchanged.

APPLICATION

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NAME(Required)
PRESENT ADDRESS(Required)
PERMANENT ADDRESS(Required)
ARE YOU 18 YEARS OR OLDER?(Required)
ARE YOU PREVENTED FROM LAWFULLY BECOMING EMPLOYED IN THIS COUNTRY BECAUSE OF VISA OR IMMIGRATION STATUS?(Required)
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IF SO MAY WE INQUIRE OF YOUR PRESENT EMPLOYER?(Required)
EVER APPLIED TO THIS COMPANY BEFORE?(Required)
EXCLUDE ORGANIZATIONS, THE NAME OF WHICH INDICATES THE RACE, CREED, SEX, AGE, MARITAL STATUS, COLOR OR NATION OF ORIGIN OF ITS MEMBERS.
GIVE THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.
Consent(Required)
The City of Nyssa is an Affirmative Action/Equal Opportunity Employer and complies with Section 504 of the Rehabilitation Act of 1973. The City of Nyssa is an Equal Opportunity Provider and Employer. We do not discriminate on the basis of race, religion, color, sex, age, national origin, If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination complaint Form, found online at http://www.ascr.usda.gov/complaint filing cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at USDA, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov

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