Form Center

Step One

How did you hear about this position:*
1. Village of Los Lunas website
2. Valencia County News Bulletin
3. Facebook post
4. Employee Referral
5. Local Communication
6. Other
Please choose the most applicable answer.
Referred by:
If you chose 'Employee Referral' above, please fill in the employee's name here.
Communication Name:
Please enter the name of the local communication who told you about this position.
Explain:
Please explain how you heard about this position opening.
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Applicant Information

WE CONSIDER APPLICATIONS FOR ALL POSITIONS WITHOUT REGARD TO RACE, COLOR, RELIGION, CREED, SEX, NATIONAL ORIGIN, DISABILITY, SEXUAL ORIENTATION, CITIZENSHIP STATUS OR ANY OTHER LEGALLY PROTECTED STATUS.
PLEASE READ THIS BEFORE FILLING OUT THE APPLICATION FORM:
A new application must be submitted for each position for which you are applying. Resumes are not accepted in lieu of an application, but may be attached for supplemental information. All applications must be completed in their entirety. Any application not completed and/or incomplete and noted to “see resume” will be considered an incomplete application and will be disqualified.

This application is an important part of the employment process. Candidates for any position may be eliminated based on an evaluation of the application. Please type or complete in ink as neatly and clearly as possible. Answer all questions to the best of your knowledge. False, incomplete or inaccurate information is cause for disqualification or discharge. As part of the application process, the Village of Los Lunas may conduct background checks on all applicants.

Thank you for your interest in the Village of Los Lunas.

If you need assistance completing this application, please contact Human Resources at (505) 352-7647.
Position Applied For*
Date of Application*
Date of Application
First Name*
Last Name*
Middle Initial/Name
Address1*
Address2
City*
State*
Zip*
Telephone Number(s)*
Best Place to Leave a Message*
E-Mail Address
Are you 16 years of age or older?*
1. Yes
1. No
If under 18, state age...
Have you ever been employed by the Village of Los Lunas before?*
1. Yes
1. No
If yes, give date(s)
If yes, give date(s) Start Date
—
If yes, give date(s) End Date
List any relatives that currently work for the Village of Los Lunas...*
Can you, after employment, submit verification of your legal right to work in the United States?*
1. Yes
2. No
Do you have a valid New Mexico driver's license?*
1. Yes
2. No
Minimum salary desired*
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.
Do you require any accommodations to perform the essential functions of the job?*
1. Yes
2. No
If yes, please explain.
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Education

EDUCATION
Name And Address Of High School*
Did you graduate?*
1. Yes
1. No
If no, do you have a GED?
1. Yes
1. No
Name And Address Of College
Number Of Years Completed
Other Schools/Education/Degrees (Specify)
Describe Any Specialized Training, Apprenticeship, Skills And Extra-Curricular Activities
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Employment History

EMPLOYMENT HISTORY
1. Employer
Job Title
Address
City
State
Zip
Telephone Number(s)
Supervisor
Dates Employed (From/To)
Dates Employed (From/To) Start Date
—
Dates Employed (From/To) End Date
Reason For Leaving
Hourly Rate/Salary
Work Performed
2. Employer
Job Title
Address1
City
State
Zip
Telephone Number(s)
Supervisor
Dates Employed (From/To)
Dates Employed (From/To) Start Date
—
Dates Employed (From/To) End Date
Reason For Leaving
Hourly Rate/Salary
Work Performed
3. Employer
Job Title
Address1
City
State
Zip
Telephone Number(s)
Supervisor
Dates Employed (From/To)
Dates Employed (From/To) Start Date
—
Dates Employed (From/To) End Date
Reason For Leaving
Hourly Rate/Salary
Additional Documents
If you need to add additional employment history or a resume, please upload your document.
List Professional, Trade, Business Or Civic Activities And Offices Held, If Applicable
Summarize Special Job-Related Skills And Qualifications Acquired From Employment Or Other Experience
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Professional References

PROFESSIONAL REFERENCES: Known to you for at least 3 years
1. Name*
Occupation/Association*
Telephone Number(s)*
Address1*
City*
State*
Zip*
2. Name*
Occupation/Association*
Telephone Number(s)*
Address1*
City*
State*
Zip*
3. Name*
Occupation/Association*
Telephone Number(s)*
Address1*
City*
State*
Zip*
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Applicant's Statement

APPLICANT'S STATEMENT:
I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I also agree that falsified information or significant omissions may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date.

I authorize all persons listed above (and on the accompanying resume, if any) to give the Village of Los Lunas any and all information concerning my previous employment and education and any pertinent information they may have, personal or otherwise, and release all parties, such persons and the Village of Los Lunas, from liability for any damage
that may result from furnishing same to the Village of Los Lunas.

I understand and agree that I may be required to take a drug screening test. I hereby give my voluntary consent for a urine sample to be collected from me and submitted for testing. I also consent to the release of the test result to the Village of Los Lunas for its use. I understand that any positive drug test result may preclude my employment.
Digital Signature*
Date*
Date
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Consent to Procurement of Consumer Credit Report

CONSENT TO PROCUREMENT OF CONSUMER CREDIT REPORT:
I understand that, as a condition of my consideration for employment with the Village of Los Lunas (“Village”), or as a condition of my continued employment with the Village, the Village may obtain a consumer report that includes, but is not limited to, my creditworthiness or similar characteristics, employment and education verification, social security verification, criminal and civil history, personal interviews, DMV records, any other public records and any other information bearing on my credit standing, credit capacity, character, general reputation, personal characteristics and trustworthiness.

I hereby authorize and consent to the Village’s procurement of such a report. I understand that, pursuant to the federal Fair Credit Reporting Act, the Village will provide me with a copy of any such report if the information contained in such report is, in any way, to be used in making a decision regarding my fitness for employment with the Village. I further understand that such report will be made available to me prior to any such decision being made, along with the name and address of the reporting agency that produced the report.
Digital Signature*
Date*
Date