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Application for Employment

  1. Have you ever been convicted of a violation of the law other than a minor traffic violation?*
  2. Are you eligible to work in the United States?*
  3. Type of employment desired*
    1. Education
    2. Employment
    3. (From Most Recent)
    4. May we contact for a reference?
    5. May we contact for a reference?
    6. May we contact for a reference?
    7. References:
      Three individuals not related to you, who you have known for at least one year:
    8. Emergency Contact:
    9. Please read the following statement carefully before signing to indicate your understanding:
      I understand that, prior to being offered employment, I may be asked to take an employment examination. In the event that I have a disability that will affect my ability to take the test, I will so inform the Township prior to the administration of the test so that a reasonable accommodation can be made if possible and reasonable. The Township reserves the right to require medical documentation regarding the need for an accommodation. I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that, if I am employed by the Township, falsified statements or omitted information on this application may result in my termination. I understand and agree that, if I am hired, my employment is for no definite period of time and may, regardless of the date of payment of my wages or salary, be terminated with or without cause, at any time, with or without notice to me. I authorize investigation of all statements contained in this application for any employmentrelated purpose. I release the listed references and all of my previous employers, except those specifically excluded,* and I authorize them to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give to you. As a condition of my employment with the Township, I agree that I will not, and may not, commence any action, claim, or lawsuit relating to my employment with the Township more than 182 calendar days after the date that I knew or should have known that a claim existed or later than the applicable limitations period established by statute, whichever is less.
    10. Leave This Blank:

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