Online Employment Application

Application for Employment

Thank you for your interest in Employment with Pierce Township. Please print clearly. All questions must be answered completely and accurately. If you have a resume or list of references, please attach to this application. A resume may not be submitted for a completed application.

Date / Time

First Name

Middle Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone/Home

Phone/Mobile

Position Requested:

Are you at least 18 years of age?

Yes

Do you have a valid drivers license?

Yes

Are you related to any current Pierce Township Employees?

Yes

Have you been previously employed at Pierce Township?

Yes

Are you a Veteran?

Yes

If hired, can you furnish proof that you are authorized to work in the U.S.?

Yes

Education

Name of High School

Address of High School

Address Line 1

Address Line 2

City

State

Zip Code

Do you have a High School Diploma or equivalent?

Yes

Name of College/Trade School

Address of College/Trade Schools

Address Line 1

Address Line 2

City

State

Zip Code

Course of Study

Degree

Name of College/Trade School

Address of College/Trade Schools

Address Line 1

Address Line 2

City

State

Zip Code

Course of Study

Degree

Name of College/Trade School

Address of College/Trade Schools

Address Line 1

Address Line 2

City

State

Zip Code

Course of Study

Degree

Employment Background

Please list all employment positions in the past 10 years beginning with your most recent. Account for all periods of unemployment

Employer

Employee Address

Address Line 1

Address Line 2

City

State

Zip Code

Employer Phone Number

Employed From

Employed To

Name & Title of Supervisor

Last position and duties

Starting position and duties

Ending Base Pay

Starting Base Pay

Other Compensation

Reason for Leaving

Employer

Employee Address

Address Line 1

Address Line 2

City

State

Zip Code

Employer Phone Number

Employed From

Employed To

Name & Title of Supervisor

Last position and duties

Starting position and duties

Ending Base Pay

Starting Base Pay

Other Compensation

Reason for Leaving

Employer

Employee Address

Address Line 1

Address Line 2

City

State

Zip Code

Employer Phone Number

Employed From

Employed To

Name & Title of Supervisor

Last position and duties

Starting position and duties

Ending Base Pay

Starting Base Pay

Other Compensation

Reason for Leaving

REFERENCES

Please list at least 3 individuals who can attest to your professional abilities/work accomplishments. No family members or individuals listed in Employment Background section

Reference First Name

Reference Last Name

Reference Address

Address Line 1

Address Line 2

City

State

Zip Code

Reference Phone/Mobile

Position or Relationship

Reference First Name

Reference Last Name

Reference Address

Address Line 1

Address Line 2

City

State

Zip Code

Reference Phone/Mobile

Position or Relationship

Reference First Name

Reference Last Name

Reference Address

Address Line 1

Address Line 2

City

State

Zip Code

Reference Phone/Mobile

Position or Relationship

Resume Upload

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EEO Policy:
Pierce Township maintains a policy of non-discrimination for all employees and applicants in every facet of the Township operations. In compliance with federal and state laws, Village of Glendale hires, trains, and promotes all qualified employees without unlawful discrimination on the basis of race, color, sex, gender identity, sexual orientation, pregnancy, age, religion, citizenship, national origin, disability, or genetic information.

I understand and agree that this application is not a contract and does not guarantee that I will be considered further in the hiring process or given an offer of employment. I also understand that if I am the successful candidate, my acceptance of any offer of employment is on an at-will basis and I agree to take any lawful medical examination, drug/alcohol screen, honesty detection examination or written examination required by Pierce Township.

I also certify that the information furnished in this application and any supporting documents is true and complete to the best of my knowledge and belief and I understand that any misrepresentation or omission of material fact on this or any other record submitted pertinent to employment will constitute grounds for immediate dismissal.

I certify that I have read, understand and will adhere to the statements above.

Signature

Date / Time of Signature

Online Application for Employment

Application for Employment

Education

Employment Background

REFERENCES