Job Application

EMPLOYMENT APPLICATION
Application must be fully completed to be considered. Please complete each section even if you attach a resume.
Personal Information
First Name *
Middle Name (Optional)
Last Name *
Address *

Street Address

Street Address Line 2

City State

Zip Code Country
Phone Number *
Email *
example@example.com
Are you legally eligible to work in the U.S? *

Yes No
Are a Veteran *

Yes No
**If selected you will be required to submit a background check prior to employment**
Position
Position you are applying for *
Please only choose one option
Available start date *

Month Day Year
Desired Pay
Education
Highest Grade Completed *
Name of School *
Location *
Degree/Diploma *

1.) Have you ever completed an application with the Township of Haverford? *

Yes No
2.) Have you ever worked for the Township of Haverford before? *

Yes No
If yes, dates of employment, department(s), supervisor(s) and reason for leaving
3.) Driver’s License Number:  Driver's License Number*   State: State of DL*
Class: Class*  Expiration Date:   Date*
*Do you have a CDL?   *
Has your driver's license ever been suspended?   *
If so, date(s) and for what reason?
4.) List any skills or training which you believe will benefit the position you are applying for:

Consent
On this (date) Date , I have completed this application and understand the contents. The information I have given is correct to the best of my knowledge and belief and does not knowingly contain any material or misrepresentations of facts, or omission of facts. I understand that any material misrepresentation of facts or omission of facts given by me shall be cause for rejection before appointment or dismissal from the Township of Haverford work force.

I authorize the Township of Haverford to investigate all statements contained in this application. I understand that if it is found that I have falsified this application I will be subject to dismissal.

I understand that all employees of the Township of Haverford are employed at will, which means that either the Township of Haverford or the employee may terminate the employment relations at any time, with or without notice and for any reason(s). Employees covered by the collective bargaining agreement will be governed by the terms and conditions of the contract.
Print Name: *
Signature *

Clear
Date

Month Day Year
Date

EMPLOYMENT APPLICATION