ORDER NO. 20220 AUTHORIZATION FOR FKANKLIN JOHNSTON, KERk COUNTY ROAD ENGINEER, TO HIRE SIDNEY BUCHANAN AS A PART-TIME/WEEKEND EMPLOYEE IN KERR COUNTY ROAD & BRIDGE DEPARTMENT On this the 25th day of April 1991, upon motion made by Commissioner Holekamp, seconded by Commissioner Oehler, the Court unanimously approved by a vote of 4-0-0 to hire Sidney Buchanan as a part-time employee in Kerr County Road & Bridge to work weekends supervising Community Service and SWAP workers, ezfective April 21, 1991 at Sb.05 per hour. DATE: April 16, 1991 TO: COMMISSIONERS' COURT FROM: Frank Johnston________ Person Requesting Budgetary Approval Road & Bridge --------------- Section/Division SUBJECT: New Hire ^ Lateral Transfer ^ Promotion ^ Merit ^ Demotion ^ Other EFFECTIVE: April 27L 1991 I wish to employ siane~ Buchanan Date Person AS a Part time/Weekend at 12/1 at a Title of Position Grade/Step salary Of $6.05 per hr In accordance to Order No. 18631 approved April 27, 1989, the following documents are submitted for your approval: • The actual application for employment along with any letters of recommendations; • The written physical report signed by the doctor,(CK-05) with completed evaluation form signed by department head, and; • The Workman's Compensation Inquiry report (verbal to Department Head and followed up by written request.) C K-01 ... ..., ~~~ D ~ y 3 (991 co°~+ ~,t 4``~ Application For Employment Follow instructions exactly. Fill out the application form completely. If items are not applicable, enter "NA". Da not leave items blank. Resumes are accepted for any additional information they contain but not in place of a completed application. Be sure to sign the application after completion. Name(Last, First, Middle) ~ l -,~ ~~ , J G ~ ~ Social Securi y Nu bcr Current Addres x, St, Apt , City, State, Zip) 1C ~ . / ~ Home//Phone (area code & ber) f/yL/ Permanent Address-if different (PO. St, A t ,City, State, Zip) 9 .~'~" .C C? t' i?. Work/Day Phone (rea code umber) Type of Position Desired D~ to Availab' Minimum Acceptable Salary Wor Status Desired Have you ever been discharg~ed/ ull Time ^ Part-Time ^Seasonal by an employer? ^ Yes L~l No If es ex lain: If position yo are applying for requires the operation of a motor vehicle, do you have a current Texas Driver's License? ~es ^ No License Number: ? ~~~ ~ /~J ^ O erator L]Commercial ~ ~~ ^Chauffeur Do you have~latives working for Kerr County? If yes, gtve names, relationships, and department ^ Yes tFJ 1V0 employed EDUCATIONAL RECORD HIGHEST GRADE COMPLETED ^1^2^3^4^5^b^7^8^9^10^11 12 Did you graduate from high school/GED? ,; r / ; ~' ~y YeS ^ I`t0 If a degree or vocational or college credits are required to meet min mum qualifications for a position you are seekin a transcri t is re uired: Name of School Location ~ Ma. Yr. Mo. Yr. Earned Yes N De ree/Certificate of Stud Busi/Tech/Voc Schools College-University Sem. Hrs Graduated? Graduate Schools Sem. Hrs. Graduated? CK-02 An Equal Opportunity/Affirmative Action Employer EtiiPLOYl~1Ei~`T RECnIZn rnNTl~Irr.n D~.rn 7 ..f d List any special course work (incluc .he number of hours completed), trail or experience that qualifies you for the classification(s) for which you are applying. Also list memberships in relevant professional organizations: ~/ .~-- List current licenses/certif'cates/registrations (indicate types and dates received) Skills: List special skills and machines or office equipment you can use (adding machines, dictation equipment, printing/graphic equipment, data processing etc) Foreign Languages (List): Speak Read Write ^ Fair ^ Good ^ Excellent ^ Fair ^ Good ^ Excellent ^ Fair ^ Good ^ Excellent , ~ % ^ Fair ^ Good ^ Excellent ^ Fair ^ Good ^Excellent ^ Fair ^ Good ^ Excellent Military Service - A co of a report of se aration from the Armed Forces DD-214 ma be re uired: Branch ~~i ~~ ~ Dates of Service Are you i the Active Reserve? ~ From To ^ Yes No EMPLOYMENT RECORD; This information will be the official record of your employment history and must accurately reflect all significant duties performed. You must provide all the information requested in order for your qualifications to be evaluated properly. Add additional sheets as needed. 1. Include ALL em to ment. Be in with our resent or last osition and work back to our first osition. 2, Include volunteer work ex erience• write the word "Volunteer" beside our title. 3. List se aratel each osition held with the same em to er, includin militar service. 4, Give name listed on a roll records, if different from current name. Job Title From (mo/day/yr) Through (moJday/yr) Final Salary / ~ l 1$ cr Name o1; rg~ zation , Address (PO.Bx, St, Apt ,City, State, Zip Ph e (area code & number) ~ ` ~ ~ f ~C J ti ~ Full- Part -Time If art-time a roximate number of hours cr week; Name of Supervisor Title of Supervisor Number and job types of employees supervised by y , if any (c.g. 3 managers, 2 technicians, 2 clerks): ~ Reason for Leaving ~~ ~ ~ L ~~ Describe the duties of your position in order of im ortance: EMPLOYMENT RECORD NTINUED Parr ~ of 4 Job Title ~~ From (mo/day/yr} Through (mo/day/yr) ~~ ~ Finaly~alary ~ S awl er Name of Organization Address (PO.Bx, S[, Apt ,City, State, Zip) Phone (area code & number) Full- Part -Time If art-time, a roximate number of hours er week: Name of Supervisor ~ T" e of Supervisor Number and job types f employees supervised by you, if any (e.g. 3 managers, 2 technicians, 2 clerks}: Reason for Leaving ~ ~~ ,~- ; ~O~J C ~ ~~ ~~ /1' C r'- Describe the duties of our osition in order of im ortance: c~c n~ j~ j1'i.ccK~ %I~t i E'E"~~ ~- c; /~ c El" C~f1"~~iD~ ~7.~~.~~ %~C ~t1~ ~ l ! Job Title ~G fi'C: From (mo/day/yr) _ Through (mo/day/yr) ~7 ~'.- ~' ~ Final Salary ~ ~ ~ er r Name of Organization ! Address (PO.Bx, St, Apt ,City, State, Zip) Phone (area code & number) Full- Part -Time If art-t me, a roximate number f hours er week: Name of Supervisor .~ ~l ~~~ Title of Supervisor f ~~L.~ -~ Number and job types of employees supervised by you, if any (e.g. 3 managers, i 2 technicians, 2 clerks): Reason for Leavin _ ~f/,' ~/ _ g ~~r ~'vv ~/%ij / f r'`~i~ ~ l'rf ~~ _ ~ r i ~ ~ I/ Describe the duties of our osition in order of im ortance: .~ ~~ I'L12SUNAL DATA: Do you have any existing physical or medical conditions or disabilities that would interfere with your ability to perform the job for which you have applied for? ^ Yes ®'~to If yes, please explain: -------------------------------------------------- ----------------------------------------------------------------------------------- Have you ever filed a Workers'sompensation claim? -~~ /' / ` Yes ^ ho lease ex lain: 4? C__~~n _~~~~_../_~r~1~~.~!1___L,X~ .: >r~~------- If yes, p p ----------------------------------------------------------------------------------- Have you ever been convicted of a crime? If yes, please explaict: __________. ^ Yes L1 do ~.:ti~rLG i 1r1~i1iT RECORD CONTINUED Page 4 of ~ - Please list 3 names of individuals willing provide character or professional re: _ nces: Please read the following statements carefully and indicate your understanding and acceptance by signing your name in the space indicated. 1. I certify that the foregoing statements as well as those on any attachment(s) to this form arc to the best of my knowledge true and correct and that they are given of my own free will. 2. I understand that any misstatement (s) or omission(s) of material facts will constitute grounds for unfavorable consideration or dismissal from employment. 3. I understand that former employers and educational institutions may be contacted for employment and educational information. f. I understand that Kerr County may contact my current employer for employment information before making a binding offer of employment. i . I understand that if employed, I will serve an initial probationary period. 5. I understand that any omissions of material facts or any false information that I give to obtain past. present, or future county (KERB) benefits may result in unfavorable considcraliort or dismissal from employment. 1. I understand that before I can be employed by the County, I must show proof of identity and U.S. citizenship or authorization to work in the U.S. (e.g. driver's license, and either a social security card or a birth certificate). ., '~ APPLICATION MUST BE SIGNED:- / ~ '' ~.~1.1._~ ~ ___ - SIGNATURE- LICANT DATE Name Address Telephone # Relation ,r-.. COUNTY OF KERR APPLICATION SUPPLEMENT Please provide the following information, which will be used for internal tracking, statistical purposes and reporting to government regulatory agencies only. This page will be separated from your application, and will in no way be used in consideration of your application for employment. Kerr County is an Equal Opportu nity Employer, and does not discriminate because of sex, age, race, color, disability, national origin, religion or sexual orien t at ion. Social Security Number: ~ 7 / _____ ~~L= / ~J~~~~~ -__-_- Name (Last, First, MI): ~ ~~~~ .5~~~ ,~~~~ t ~" ----- ~' - Address (Street Address) ____~~ _~ //~ J~~1~l" _~~ t~,~ ~___-___ __ cc ~~ 77 '' City, State, Zip ~~ r ~ i 2~~%~~~ ~-.~~A~`t~-- - ----------- ---- Home Phone ( ~ f ~ ) ~ ~~~ ~ ~c~~l Alternate Phone ( ) Are you a U.S. Citizen? L- ~~ Please Check One: A. ~ White Male F. Hispanic Female B. White Female ~ American Indian/Aleutian Male C. Black Male H. American Indian/Aleutian Female D. Black Female I. Asian/Filipino/Male E. Hispanic Male J. Asian/Filipino/Female Disabled: Yes ~/No (Please indicate the nature of your primary disability) A. Hearing Impaired D. Speech Impaired B. Mobility Impaired E. Other (Specify) C. Vision Impaired Are you currently, or ave you previously been employed by the County? Yes No If yes, when? Department What led you to apply with the County (Check One) 1. Stopped in to check on available jobs 2. Referred by a County Employee 3. Referred by an employment agency 4. Responding to an advertised vacancy 5. R erred by T.E.C. ~~ / ~/~~ 6. ~fOther (Please List) /~C ~~ ,~ cl D ~ ~~ ~ ~ ,C Please indicate below the title of each position for which you are submitting an application today: C l<~ fir, ~-~i_= t' - Job Title - ~`~-~-- 4. Gt.: ~. ..~ r ` -- ~ CK-03 FILE SEPARATELY FROM ~!:PPL1CATlON ~~'~ COMMISSIONERS' COURT AGENDA REQUEST ~' I i PEASE FURNISH ONE ORIGINAL ,AND FIVE COPIES OF THIS REQUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT MADE BY: Frank Johnston OFFICE: Raac~ & 8ridg~ April 25, 1991 MEETING DATE: TIME PREFERRED: j SUBJECT: (PLEASE BE SPECIFIC) airing of part-time employee for weekend work to sunervisP Cnmmun;t~ Sarvirc x. c L.T n,n workers. EXECUTIVE SESSION REDUESTED: YES _ NO PLEASE STATE REASON ESTIMATED LENGTH OF PRESENTATION: PERSONNEL MATTER - NAME OF EMPLOYE: 5 minutes Sidney Buchanan NAME OF PERSON ADDRESSING THE COURT: Frank Johnston Time for submitting this request for Court to assure that the matter is posted in accordance with Article 6252-17 is as follows: * Meetings held on second Monday: 12:00 P.M. previous Wednesday * Meetings held on Thursdays: 5:00 P.M. previous Thrusday THIS REQUEST RECEIVED BY: ~ - THIS REQUEST RECEIVED ON : ~} - i 7 - ~~ ~ ~ ~ ~ ~~ =" ~--1-~-- -- All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court meetings. Your cooperation will be appreciated and contribute towards your request being addressed at the earliest opportunity. See Agenda Request Guidelines.