Job application

Application for Employment

Town of Castleton, Vermont
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Name

First NameLast Name
Full Name*

First NameMiddle InitialLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail*
Phone Number*

Area CodePhone Number
Are you able to submit proof that you are legally permitted to work in the United States?

YesNo
Position Applied for:
Other positions you may be qualified for:
Available start date:*

MonthDayYear
Do you have a valid driver's license?

YesNo
Have you served in the U.S. Armed Forces?

YesNo
If Yes, Branch:
Have you ever been employed by the Town of Castleton

YesNo
Position:
Department:
Are you related to any Town of Castleton employee?

YesNo
Name of Employee:
Relationship:
Department:
Education:
Are you a High School Graduate?

YesNoHigh School Eqivalency earned
High School Equivalency?

YesNo
Are you presently attending school?

YesNo
Education
Name of Institution
Field of Study
Type of Degree
Did you Graduate?

YesNo
Do you have additional education to enter?

YesNo
Additional Education
Name of Institution
Field of Study
Type of Degree
Did you Graduate?

YesNo
Professional License or Certificate, If Required
Type
Serial Number
Date Issued
Expiration Date

MonthDayYear
Skills

Describe your skills, experience, certifications or other training that may be relevant to the position your are applying for (include any memberships to trade or professional organizations).
Computer Skills:

YesNoOther
Equipment/ Tools Operated
List experience with job related equipment
Computer Programs/skills
List computer programs used/skills mastered
Employment History

Beginning with your present or most recent experience, account for all employment during the past ten (10) years. To elaborate, a supplemental sheet or resume may be attached, but cannot be substituted for a completed application. Include military service if applicable.
Most Recent Employer:
Date started

MonthDayYear
Date ended

MonthDayYear
Employer Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer Phone Number

Area CodePhone Number
Job Title:
Supervisor:
May we contact this employer?

YesNo
Description of Duties:
Reason for Leaving:
Do you have additional employers to enter?

YesNo
Name of Employer:
Date started

MonthDayYear
Date ended

MonthDayYear
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Job Title:
Supervisor:
May we contact this employer?

YesNo
Description of Duties:
Reason for Leaving:
Professional References

*Additional references can be attached
Full Name

First NameLast Name
Business or Occupation
Phone Number

Area CodePhone Number
Full Name

First NameLast Name
Business or Occupation
Phone Number

Area CodePhone Number
APPLICANT’S STATEMENT AND AUTHORITY TO RELEASE INFORMATION

(Required for ALL Positions)

I understand that this employment application and any other Town documents are not contracts of employment, and any person hired may be terminated by the employer at any time for any reason. I understand that any oral or written statements to the contrary are expressly disavowed and should not be relied upon by a prospective or existing employee. I understand that Town of Castleton may modify, change, or revoke any of its employment policies, pay practices, and benefits without my agreement. I hereby state that all answers on this application are true and understand that falsifying this information can lead to termination if hired. I UNDERSTAND THAT IN ACCORDANCE WITH TOWN POLICY, FINAL CANDIDATES FOR FULL TIME POSITIONS MAY BE SUBJECT TO AN ALCOHOL / DRUG TEST AS A CONDITION OF EMPLOYMENT.

I hereby authorize any and all persons, companies, or agencies to release any and all background information, of a confidential or privileged nature, including criminal history, relevant to this application and any pertinent information they may have to the hiring authorities of the Town of Castleton. I release all such parties from all liability of every kind as the result of furnishing the same to Castleton. This information is to be used to assist the Town in determining my qualifications and fitness for the position I am seeking. I hereby release the Town of Castleton and its Select Board, officers, agents and employees from any liability for the use of any and all of the foregoing information, in consideration for being reviewed for the aforesaid position.

Should there be any questions regarding the validity of this release, you may contact me as indicated below.
Please attach your resume if available

Upload a File
Resume or additional relevant information can be attached. Cancelof
CERTIFICATION BY APPLICANT (Read carefully before signing.) All information provided by me is true and correct to the best of my knowledge. I understand omissions or misrepresentations may be cause for rejection or, if employed, may be just cause for dismissal. I hereby authorize any former employer, person, firm, corporation or educational institution listed herein including this municipality to answer any and all questions and provide documents and agree to hold all persons harmless for giving any and all truthful information within their knowledge or records. I understand this is a preliminary application and not a contract to employ me. Furthermore, in the event I am hired, my employment shall be completely voluntary. I agree to comply with all reasonable rules of the municipality as a condition of employment.
Town of Castleton is an equal opportunity employer. It is the policy of this municipality to provide equal employment opportunity to all applicants and employees without regard to race, color, religion, sex, national origin, ancestry, place of birth, age, marital status, pregnancy status, genetic information, physical or mental condition, HIV status, veteran status, sexual orientation, gender identity, or other category protected by state or federal law. No question is asked on this application or during the application process for the purpose of excluding any applicant due to the aforementioned protected categories or other category protected by state or federal law.
Signature
EQUAL EMPLOYMENT OPPORTUNITY QUESTIONAIRE
Date

MonthDayYear
Full Name

First NameLast Name
How did you learn about this position?

Employment OfficeTown EmployeeSchoolNewspaperInternetCareer FairWalk-InOther
Gender

MaleFemale
Race/Ethnic Origin (Select ONLY One)

White (not of Hispanic origin): Persons having origins in any of the original people of Europe, North Africa, or the Middle East.Black (not of Hispanic origin): Persons having origins in any of the black racial groups of Africa.Hispanic: Persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish cultures or origins regardless of race.Asian or Pacific Islander: Persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This includes, for example, China, India, Japan, Korea, the Philippine Islands, and Samoa.American Indian or Alaskan Native: Persons having origins in any of the original people of North American and who maintain cultural identification through tribal affiliation or community recognition.
If Yes, Please explain:
Date

MonthDayYear
Date
Should be Empty:

Application for Employment

Education:

Professional License or Certificate, If Required

Skills

Employment History

Professional References

EQUAL EMPLOYMENT OPPORTUNITY QUESTIONAIRE