Skip to form

City of Andalusia Human Resources

P.O. Box 429 Andalusia, AL 36420


The City of Andalusia
Employment Application

The City of Andalusia is an Equal Opportunity Employer. 

The City of Andalusia will provide equal opportunity to all individuals and will employ applicants on the basis of their job-related qualifications and performance potential without regard to age, sex, religion, race, color, national origin, disability, political affiliation, or military status.  

Please check that you agree before continuing.
By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored.

General Information

Additional Information

Emergency Contact

In the event of an emergency, who should we notify?

Date of Birth

If applying for Police and/or Fire Department, date of birth required.

Job Interest / Skills

Type of employment requested

For Our Reference

Have you applied for a position here before?

Have you ever been employed with the City of Andalusia?

If yes, please complete:

Does the City of Andalusia employ any of your relatives?

If yes, please complete:

Have you ever been known by any other name(s) which the City will require to verify the information contained in this application?

Employment History

List your current or most recent employer first and indicate a continuous record of employment for the last ten years or from the time you left school.

May we contact this employer?

May we contact this employer?

May we contact this employer?

May we contact this employer?



Specialized Training/Skills

Military Record

Have you ever served in the armed forces?

Miscellaneous Information

Have you ever been convicted of a crime other than a minor traffic violation? A conviction record will not necessarily be a bar to employment.

Can you verify your legal rights to work in the U.S. by providing a birth certificate, proof of U.S. Citizenship, or by some other means?

Are you able to perform the job for which you are applying?

The City of Andalusia requires that all qualified applicants undergo a pre-employment physical examination and drug screen prior to employment. The City will pay the costs of such physical examinations provided the applicant begins work with and remains in the employ of the City for a minimum of 60 days. If the 60-day requirement is not met, the applicant shall be responsible for paying such examination charges. The City may deduct such charges from the employee's final pay.


Personal references, not former employers or relatives


How were you referred to the Personnel Office?


I certify that the answers given by me in this application are correct to the best of my knowledge. I understand that any falsification of this application, whether intentional or accidental, is grounds for disqualification of employment consideration or dismissal from employment if I am hired. I authorize the City of Andalusia to contact any and all of the references and previous employers I have listed to obtain previous employment information or any other pertinent information that they may have. Further, I release the City of Andalusia and the above mentioned references from any and all liability for any damages that may result from information collected by the City of Andalusia. 


Verification of eligibility to work in the United States will be required. 


I further acknowledge and agree that no manager or representative of the City of Andalusia has any authority to enter into any employment contract. I understand and agree that, if I am employed, I will be an at-will employee during my probation period and the City of Andalusia may terminate my employment at any time during that probationary period. 


I have read the above and I concur with the above as a condition of employment by the City of Andalusia, Alabama.