Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Application for Employment

  1. Roch_Seal_COLOR
  2. The City of Rochester is an equal opportunity employer and shall consider all qualified applicants for all positions without regard to race, color, sex, religion, national origin, age, height, weight, marital status, family status, veteran status, physical or mental disability, sexual orientation, gender identity or any other protected category. We provide reasonable accommodation for qualified individuals with a disability if requested.

    Type or print in blue ink. You are required to answer all questions completely, even if you enclose a resume. Extra pages may be attached if you need them. You are responsible for complying with any application deadlines. This form may be turned in at the Human Resources Department, mailed to the above address, faxed to (248) 733-3170, or emailed to

  3. Note:

    If you are applying for a position within the Police Department, please either call them at 248-651-9621 with your Driver's License number, or fax your Driver's License to 248-963-0799 with a memo indicating the application position.

  4. Are You 18 Years of Age or Older?
  6. Did you graduate?
  7. Did you graduate?
  8. Did you graduate?
  9. Did you graduate?
  11. Employment Status
  12. Employment Status
  13. Employment Status
  14. Employment Status

    (Do include former employers)

  16. Are you a relative by birth or marriage to any City of Rochester employee or elected official?
  17. What kind of employment are you interested in? Check as many as you like.
  19. Have you had any experience in the Armed Forces of the United States of America or in a State National Guard?

    (If yes, please attach DD214)

  21. I certify that the information in this application is true, complete and correct to the best of my knowledge and understand that falsification, misleading, misrepresentation, or omission of any information submitted in connection with my application or interview, whether in this document or not, may result in rejection of my application or, if hired, in dismissal.
  22. *By typing/signing your name electronically on this Application you are agreeing that your electronic signature is the legal equivalent of your manual signature.
  23. Leave This Blank:

  24. This field is not part of the form submission.