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Executive Summary

This document is an employment application form for the Township of Dennis, located in Dennisville, NJ. It requests standard applicant information such as contact details, employment history, references, and eligibility to work. Applicants are advised that background checks will be conducted.

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--- Document: Download Employment Form (PDF) Document ---
          
TOWNSHIP OF DENNIS  
                                         571 PETERSBURG ROAD, PO BOX 204 
DENNISVILLE, NJ 08214 
                                                                                            WWW.DENNISTWP.ORG    (609)861-9700 
 
 
EMPLOYMENT APPLICATION 
Please be advised that background checks will be conducted. 
 
Position(s) applied for: ___________________________________________________________________ 
Name: __________________________________________________________________________________ 
Address: ________________________________________________________________________________ 
Home Phone: _________________________________  
Cell Phone: ________________________ 
Email Address: ___________________________________________________________________________ 
Are you over the age of 18?  
 
 
 
 
 
 
Yes  
 
No 
 
If No, can you provide proof of eligibility to work?  
 
Yes  
 
No 
Are you a citizen of the United States?  
 
 
 
 
Yes  
 
No 
Are you prevented from lawfully becoming employed in this Country because of Visa or 
Immigration Status? (proof of citizenship or immigration status will be required) 
Yes 
 
No 
Have you ever filed an application with the Township before?  
Yes 
 
No 
If Yes, when & what position? ______________________________________________________ 
Have you ever been employed by the township before? 
 
Yes 
 
No 
If Yes, when & what position? ______________________________________________________ 
Have you ever been bonded?  
 
 
 
 
 
Yes  
    
No        
If Yes, at what job(s)? _____________________________________________________________ 
Are you currently employed?       
 
 
 
 
 
Yes  
 
No        
If Yes, may we contact your employer?  
 
 
 
Yes  
     
No        
On what date would you be available to begin work? ___________________________________ 
What type of work are you available for? 
Full Time 
Part Time 
Seasonal 
Temp 
Are you currently on layoff status?  
 
 
 
 
 
Yes 
      
No    
 If Yes, are you subject to recall?  
 
 
 
 
Yes         
No 
What method of transportation will you use to get to work? ________________________________ 
 


EMPLOYMENT APPLICATION  
Are you currently disqualified from public employment due to a criminal conviction for which 
N.J.S.A. 2C:51-2.d applies? 
 
 
 
 
 
 
Yes 
 
No 
Have you ever been convicted of a crime, excluding misdemeanors and summary of 
offences?    
 
 
 
 
 
 
 
 
Yes  
 
     No        
If Yes, please describe in full: ______________________________________________________________ 
__________________________________________________________________________________________
__________________________________________________________________________________________ 
List any friends or relatives currently or previously employed by the Township: _______________ 
__________________________________________________________________________________________
__________________________________________________________________________________________ 
__________________________________________________________________________________________ 
Name of most recent employer: __________________________________________________________ 
Address: ________________________________________________________________________________ 
Job Title: ________________________________________________________________________________ 
Date Started: _____________________________ Date ended: _________________________________ 
Annual Salary or Hourly Wage: ___________________________________________________________ 
Reason for leaving: ______________________________________________________________________ 
__________________________________________________________________________________________ 
Name of previous employer: _____________________________________________________________ 
Address: ________________________________________________________________________________ 
Job Title: ________________________________________________________________________________ 
Date Started: _____________________________ Date ended: _________________________________ 
Annual Salary or Hourly Wage: ___________________________________________________________ 
Reason for leaving: ______________________________________________________________________ 
__________________________________________________________________________________________ 
Name of previous employer: _____________________________________________________________ 
Address: ________________________________________________________________________________ 
Job Title: ________________________________________________________________________________ 
Date Started: _____________________________ Date ended: _________________________________ 
Annual Salary or Hourly Wage: ___________________________________________________________ 
Reason for leaving: ______________________________________________________________________ 


 
EMPLOYMENT APPLICATION  
Please list at least three Personal References (DO NOT list relatives) 
Name: __________________________________________________________________________________ 
Address: ________________________________________________________________________________ 
 
Occupation: ________________________________________  Phone: ____________________________ 
__________________________________________________________________________________________ 
 
Name: __________________________________________________________________________________ 
Address: _________________________________________________________________________________  
 
Occupation: ________________________________________  Phone: ____________________________ 
__________________________________________________________________________________________ 
 
Name: __________________________________________________________________________________ 
Address: ________________________________________________________________________________ 
 
Occupation: ________________________________________  Phone: ____________________________ 
__________________________________________________________________________________________ 
 
Please list any Professional, Business or Civic Activities (include certifications and professional 
designations): ___________________________________________________________________________ 
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________ 
You may exclude membership(s) which would reveal gender, race, religion,  
national origin, age, ancestry, disability, or other protected status. 
__________________________________________________________________________________________ 
 
Signature of Applicant: _________________________________ 
 
Date: _________________ 
 
If under 18 years of age, Signature of Parent/Guardian: ____________________________________ 
__________________________________________________________________________________________ 
FOR TOWNSHIP USE ONLY  
 
Application Received by: _________________________________________ Date: _________________