Application for Employment

The Charter Township of Redford 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, veteran status, handicap, or any other protected category.

YOU MUST ANSWER ALL QUESTIONS COMPLETELY AND TRUTHFULLY. FAILURE TO DO SO WILL RESULT IN REJECTION OF YOUR APPLICATION (YOU WILL NOT BE CONSIDERED FOR EMPLOYMENT), OR, IF NOT DISCOVERED UNTIL A LATER DATE, MAY RESULT IN DISCIPLINE OR DISCHARGE FROM EMPLOYMENT

Position Applied For*

Name*

First NameMiddle NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Telephone

Please enter a valid phone number.

Cell Phone

Please enter a valid phone number.

Email Address*

example@example.com

Personal Information

Type of license

Operator's licenseCommercial Driver's license (CDL)Chauffeurs

Driver's License No.

(A license check will be conducted for applicants for positions requiring a current driver's license)

Have you ever tested positive, or refused to test for any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety sensitive transportation work covered by a U. S. Department of Transportation agency drug and alcohol testing rules in the two years prior to the date of this application?

YesNo

Are you a relative by birth or marriage to any Charter Township of Redford elected official or full-time management employee?

YesNo

If Yes, please provide their name and relationship:

Are you under 18 years of age? (If yes, attach work permit)

YesNo

Are you currently working?

YesNo

Are you on lay-off

YesNo

If yes, are you subject to recall?

YesNo

Will you submit to a drug screening test?

YesNo

Have you ever been employed by the Charter Township of Redford?

YesNo

If Yes, please provide employment details:

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status? (proof of citizenship or immigration status is required upon employment)

YesNo

Have you ever been fired?

YesNo

If Yes, give date, where you worked, and an explanation:

Have you ever been convicted of a felony?

YesNo

If Yes, completely describe including location and date:

NOTE: A conviction record will not necessarily be a bar to employment. Factors such as age, time of offense, seriousness and nature of violation, and rehabilitation will be considered.

Are you capable of performing with or without reasonable accommodation (special assistance, equipment or other help), the activities involved in the job or occupation for which you have applied?

YesNo

	High School	Vocational/ Technical	College	Graduate School
School Name City/State
Did you Graduate? (If not number of credit hours completed)
Degree/Certificate
Major/Minor

Describe any specialized training, apprenticeships, internships, skills, licenses, certificates, and extra-curricular ac tivities that pertain to the position(s) for which you are applying.

List professional, trade, business group memberships, and offices held, and volunteer work excluding groups the name and character of which indicate race, color, sex, religion, national origin, age, height, weight, marital status, veteran status, handicap, or any other protected class:

(Do not include relatives or former employers):

Reference 1

Reference 2

Reference 3

Have you had any experience in the Armed Forces of the United States of America or in a State National Guard that is directly related to the position for which you are applying?

YesNo

If Yes, please provide branch and discharge details:

Were you honorably discharged?

YesNo

NOTE: A dishonorable discharge from the military will not necessarily be a bar to employment.

List each job held within the last 20 years. Start with your present or last job first. NOTE: If more space is needed copy this page first.

Job #1

Job #2

Job #3

Job #4

Job #5

Job #6

Job #7

Job #8

Job #9

Job #10

Please read carefully before signing

1. I authorize the references and current and former employers listed in this application to give you any and all information concerning my current and previous employment and any pertinent information they may have, including disclosure of any disciplinary reports (even if more than four years old), and release all parties from any liability for any damages that may result from furnishing same to you. I further authorize you to release such information when such information may be requested by any prospective or subsequent employers without the need to provide me any notice of such disclosure.
2. I understand that the use of this application does not indicate that there are positions available, nor does it imply or create an employment contract. I understand that the only employment contracts are those specifically authorized by Redford Township management that have been reduced to writing and have been executed by both the employee and an authorized representative of Redford Township. Accordingly, I understand that no employment contract, either expressed or implied, for any period, is created hereby should Redford Township hire me.
3. If hired, I understand that my employment is at-will (just cause for union and/or civil service employees), and can be terminated at any time, with or without notice, for any reason at the option of either Redford Township or me. Should Redford Township hire me, I agree to observe all of Redford Township's policies, practices, and procedures currently in existence and new and revised ones that may be issued in the future.
4. I understand that any employment offer is conditional upon the result of the drug screening test, post offer pre-employment medical examination, and background investigation (when applicable based on the position sought).
5. I understand that if I have a physical, mental, or other impairment that would interfere with my ability to perform in a position but that may be accommodated by, for instance, the purchase of equipment or devices, the provision of readers or interpreters, or the restructuring or altering of work schedules, the Michigan Persons With Disabilities Civil Rights Act requires me to notify the Employer's Personnel Department in writing of need for accommodation within 182 days after I knew or should reasonably have known that the accommodation was needed.
6. I agree that any lawsuit against Redford Township arising out of my employment or termination of employment, including but not limited to, claims arising under the State or Federal Civil Rights statutes, must be filed within six months of the event giving rise to claims or be forever barred. I waive any limitations period to the contrary.

For circumstances in which the statutory period of limitations is less than six months, the statutory limit will apply.

I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS OF EACH OF THE ABOVE SIX (6) INDIVIDUAL STATEMENTS, AS INDICATED ABOVE.

Signature

DATE

Date

APPLICATION FOR EMPLOYMENT

Personal Information

EDUCATION

REFERENCES

MILITARY SERVICE RECORD

EMPLOYMENT HISTORY

WAIVERS AND ACKOWLEDGMENTS