Metropolitan Airport Authority of Peoria
6100 W. Dirksen Parkway
Peoria, IL 61607
APPLICATION FOR EMPLOYMENT
Equal Opportunity Employer: In compliance with Federal, State and Local employment opportunity laws, the
Metropolitan Airport Authority of Peoria (“MAAP”) will consider all qualified candidates for employment
without regard to race, color, creed, religion, sex, sexual orientation, age, marital status, military status,
certain unfavorable discharges from military service, citizenship, ancestry, national origin, physical or mental
handicap or disability or any other characteristic protected by law.
Accommodations: Consistent with the Americans with Disabilities Act, you may request accommodations
needed to participate in the application process.
Application Instructions: Please print and fill out application completely – do not refer to resume. Incomplete
applications may prevent you from being considered for employment. Applications will remain active for
thirty (30) days.
Personal Information
Name (Last, First, M.I) Social Security Number
Street Address (include Mailing Address if different) Home Telephone
City, State, Zip Work Telephone
E-mail address May we contact you at work? Are you 18 years of age or older?
Yes No N/A Yes No
How did you learn about us? Friend Relative Walk-In Employee (specify) ________________
Advertisement (specify)_____________________ Employment Agency (specify)__________________________
Internet Website (specify which site) ___________________________________________________________________
MAAP is required to verify an employee’s lawful right to work in the United States. If hired, will you be able to provide this
required documentation?
Yes No
MAAP must conduct criminal background verification on every applicant. Please complete the Criminal Background
Verification on pages 5 and 6.
Have you been convicted of any crime within the past ten (10) years?* Yes No
If Yes, give date of conviction and specific information: _______________________________________________________
___________________________________________________________________________________________________
*NOTE: You are not obligated nor will MAAP ask you to disclose sealed or expunged records of convictions or
arrests. Conviction does not necessarily disqualify an applicant from employment. The severity, pertinence and
date of the conviction will all be considered.
Employment Desired and Hours Available
Position(s) Applying For Date Available Salary Desired
Type of work desired
Please rank in order of preference, or mark N/A for “not applicable”:
____Full-time ____Part-time, over 20 hrs per week
____Part-time, under 20 hrs per week ____Seasonal/Temporary (explain)____________________________
Hours
available to Monday Tuesday Wednesday Thursday Friday Saturday Sunday
work: *
From
To
Total hours available per week Are you able to work beyond your assigned shift or work overtime if needed? *
Yes No
Are you now under any non-competition obligations, or do you have any other interest, which is inconsistent or in conflict with
duties that may be assigned by MAAP? Yes No
Have you ever applied with us before? For What Position? When?
Yes No
Have you ever been employed with us In What Position? When?
before?
Yes No
Do you have any relatives that are Who? What Department?
currently working for us?
Yes No
* NOTE: You are not obligated nor will MAAP ask you to disclose whether you might request time off during these hours
for religious practices. Applicants who require an accommodation for religious practices will not be excluded from
consideration or otherwise subject to discrimination.
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Education
Name of School
Course of Study Years Completed Did you graduate? Degree Earned
City, State
High School 1 2 3 4 Yes No
College/University 1 2 3 4 5+ Yes No
Trade, Business,
Correspondence 1 2 3 4 Yes No
School or Other
Please list special skills and/or qualifications you possess that directly relate to the position for which you are applying, such as
knowledge of software, computer programs, and machinery and/or other office equipment you operate:
Please list workshops, courses, certification, or training you have completed that directly relate to the position for which you are
applying:
Why are you interested in MAAP and/or this position?
_______________________________________________________________________________________________
Employment History
Instructions: List your last four previous employers below, starting with your most recent employer. Attach additional
sheets if necessary. Explain any gaps in employment at the end of the page. All information MUST be completed. You
may not substitute a resume for this application, although a resume may be attached for additional information.
Employer #1 --- Current or Most Recent Employer
May we contact your current employer? Yes No If no, please explain: __________________________________
Employer Name From (mo/yr) To (mo/yr) Employment was:
Employer Address, City, State Employer Telephone Start Position End Position Full-time
Part-time
Seasonal/Temp
Supervisor Name Start Salary End Salary Are you currently employed
with this company?
Yes No
Duties performed and skills used or learned: Reason for leaving or looking for other
employment:
___________________________________
Voluntary Involuntary
Employer #2
Employer Name From (mo/yr) To (mo/yr) Employment was:
Employer Address, City, State Employer Telephone Start Position End Position Full-time
Part-time
Seasonal/Temp
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Supervisor Name Start Salary End Salary Are you currently employed
with this company?
Yes No
Duties performed and skills used or learned: Reason for leaving or looking for other
employment:
___________________________________
Voluntary Involuntary
Employer #3
Employer Name From (mo/yr) To (mo/yr) Employment was:
Employer Address, City, State Employer Telephone Start Position End Position Full-time
Part-time
Seasonal/Temp
Supervisor Name Start Salary End Salary Are you currently employed
with this company?
Yes No
Duties performed and skills used or learned: Reason for leaving or looking for other
employment:
___________________________________
Voluntary Involuntary
Employer #4
Employer Name From (mo/yr) To (mo/yr) Employment was:
Employer Address, City, State Employer Telephone Start Position End Position Full-time
Part-time
Seasonal/Temp
Supervisor Name Start Salary End Salary Are you currently employed
with this company?
Yes No
Duties performed and skills used or learned: Reason for leaving or looking for other
employment:
___________________________________
Voluntary Involuntary
Gaps in Employment
Dates Explain gaps in employment longer than 30 days Not Applicable
From To Reason
From To Reason
From To Reason
Other References
Instructions: List four references you have known for at least one year. Do not list persons related to you or persons
already listed in the Employment Section.
Years Relationship
Name/Occupation Address, City, State Telephone (Check all that
Acquainted apply)
Work-related
1.
Personal
Work-related
2.
Personal
Work-related
3.
Personal
Work-related
4.
Personal
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Criminal Background Verification
Where specific citations are listed, both the current citation and the citation that applied before the statues are
recodified in 1994 are listed.
Yes No
Forgery of certificates, false making of aircraft, and other aircraft registration violations, 49 U.S.C 46306
[formerly U.S.C. App.1472(b)]
Interference with air navigation, 49 U.S.C. 46308 [formerly 49 U.S.C App. 1472(2)]
Improper transportation of a hazardous material, 49 U.S.C 46312 [Formerly 49 U.S.C. App. 1472(b)(2)]
Aircraft piracy, 49 U.S.C. 46502 [formerly 49 U.S.C. Ap. 1472(j)]
Interference with flight crew members or flight attendants, 49 U.S.C. 46504 [formerly 49 U.S.C. App. 1472(j)]
Commission of certain crimes aboard aircraft in flight, 49 U.S.C 46506 [formerly 49U.S.C. App. 1472(k)]
Carrying a weapon or explosive aboard an aircraft, 49U.S.C. 46505 [formerly 49 U.S.C. App. 1472(i)]
Conveying false information and threats, 49U.S.C. 46507 [formerly 49U.S.C. App. 1472(m)]
Aircraft piracy outside the special aircraft jurisdiction of the United States, 49U.S.C. 446502 [formerly 49U.S.C
App. 1472(n)]
Lighting violations involving transporting controlled substances, 49 U.S.C. 46315 [formerly 49U.S.C. App.
1472(q)]
Unlawful entry into an aircraft or airport area that serves air carriers or foreign air carriers contrary to established
security requirements, 49 U.S.C. 46314 [formerley49 U.S.C. App. 1472(r)]
Destruction of an aircraft or aircraft facility, 18 U.S.C. 32
Murder
Assault with intent to murder
Espionage
Sedition
Kidnapping or hostage taking
Treason
Rape or aggravated sexual abuse
Unlawful possession, use, sale, distribution, or manufacture or and of an explosive or weapon
Extortion
Armed robbery
Distribution of or intent to distribute a controlled substance
Felony arson
Felony unarmed robbery
Felony involving a threat
Felony involving willful destruction of property
Felony involving importation of manufacture of a controlled substance
Felony burglary
Felony theft
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Felony involving dishonest, fraud, or misrepresentation
Felony possession of distribution of stolen property
Felony aggravated assault
Felony bribery
Felony involving illegal possession of a controlled substance punishable by a maximum term imprisonment of
more than 1 year
Any other crime classified as a felony that the FAA administrator determines indicates a propensity for placing
contraband aboard an aircraft in return for money
Conspiracy or attempt to commit any of the aforementioned criminal acts
Application Notification and Authorization
Read the following information carefully before signing below.
I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any false
statement, omission, or misrepresentation of these facts may be grounds for rejection of this application, denial of employment or, if
employed, for dismissal if subsequently discovered.
In connection with my application for employment with MAAP, I understand that investigations and inquiries may be made
concerning my background and qualifications, including but not limited to my past employment or employment references,
education, credit history, criminal convictions and history, motor vehicle reports, and other inquiries. By signing this
application/statement, I hereby authorize and release without reservation all parties, including MAAP and its employees or
representatives, from any and all claims, actions, suits and/or liabilities arising from the release or pursuit of any such information. I
understand that this release does not operate to relieve any party of liability under applicable non-discrimination and fair
employment practices laws. In the event MAAP uses an outside investigative consumer-reporting agency, MAAP will notify me.
I understand that filling out this form does not indicate there is a position open and does not obligate MAAP to hire me. If hired, I
understand that I will be required to submit documents sufficient to establish employment authorization and identity in compliance
with the Immigration Reform and Control Act of 1986. In consideration of my employment, I agree to abide by the rules and
regulations of MAAP.
I understand and agree that, if hired, I will abide by the employment guidelines established by MAAP including the guidelines on
employee conduct. As a condition of employment, I acknowledge that I received, read, and if hired, agree to strictly abide
by MAAP’s Sexual and Other Discriminatory Harassment Policy, Disclosure and Non-Retaliation Policy, and
Computer/Internet/E-Mail Policy. Conduct, whether intentional or unintentional, which results in the harassment of others,
regarding race, color, religion, sex, age, national origin, sexual orientation, disability or any other protected characteristic as
established by federal, state, and local law is illegal and will not be tolerated. Such conduct violates MAAP policy and will result in
disciplinary action, up to and including termination.
I understand and agree that, if hired, my employment is for no definite period and regardless of the date of payment of my wages or
salary, and my employment can be terminated at any time, with or without cause or notice, at the option of either MAAP or myself. I
further understand that only MAAP’s Director of Airports or another person specifically designated by MAAP’s Director of Airports
has the authority to create or enter into any employment agreement on behalf of MAAP and this employment agreement will not be
enforceable unless it is in writing and signed by MAAP’s duly authorized representative and me.
Applicant Signature: Date:
We appreciate your interest in our organization. Thank you for taking the time to complete this application.
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