Document Text
--- Document: Employment Application Document ---
TOWNSHIP OF DOWNE
288 Main Street
Newport, NJ 08345
856-447-3100 – Phone
856-447-3533 – Fax
downetownship@comcast.net – Email
APPLICATION FOR EMPLOYMENT
Township of Downe is an Equal Opportunity Employer and Affirmative Action Employer committed to
excellence through diversity. Employment offers are made on the basis of qualifications and without regard to
race, sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation.
PLEASE TYPE OR PRINT. Complete the entire application. You may attach a resume, but you must still
complete all questions; or your application will be deemed incomplete and may not be considered.
Applications with missing will not be considered for any position.
Position Applying For:
Date
Name (Last, First, Middle):
Street Address:
City:
State:
Zip:
Social Security Number:
Home Phone:
Work Phone:
Other Phone:
Have you ever applied to the Township of
Downe before:
Yes
No If YES, give date
Are you eligible to work in the US?
Yes
No If YES, can you provide proof of eligibility to work?
Are you 18 years of age or older?
Yes
No If NO, what is your current age?
Are you currently employed?
Yes
No If YES, please state company, current job title &
department?
May we contact your current employer?
Yes
No
Contact Information:
Are you related to any current
(Township of Downe employee)?
Yes
No If YES, their name & their relationship to you?
If required for position, do you have a
valid driver’s license?
Yes
No If YES, State of issuance, license #, and expiration date:
If required for position, do you have a
valid commercial driver’s license (CDL)?
Yes
No Please list any endorsements:
Are you currently on layoff status and
subject to recall:
Yes
No
Have you ever pleaded guilty or been
found guilty of a crime or disorderly
persons offense?
Yes
No Employment is conditional upon the results of the criminal
background check. An answer of “Yes” may disqualify you
from employment depending upon the circumstances
involved. If “Yes” please explain below
EDUCATION: Provide information on your formal schooling and education. Include elementary, secondary,
and post-secondary education, if any. Include any formal vocational or professional education. For high school
and post-secondary education, indicate any major or specialty, such as Academic, Business, or Trade.
Name of School
City/State
Did you
graduate?
If No, # of
years left to
graduate
If Yes, date
of
Graduation
Degree
received
Major
High School:
Yes
No
GED:
Yes
No
Other School:
Yes
No
College:
Yes
No
College:
Yes
No
Other credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are applying.
SKILLS: Please list technical skills, clerical skills, trade skills, etc., relevant to this position. Include relevant computer
systems and software packages of which you have a working knowledge, and note your level of proficiency (basic,
intermediate, expert)
REFERENCES: Please provide the names, addresses and phone numbers of three people who we may contact as a
reference. They should not be relates or former supervisors.
Name & Address
Phone Number
Years Known
WORK EXPERIENCE-Please detail your entire work history. Begin with your current or most recent
employer. If you held multiple positions with the same organization, detail each position separately. Attach
additional sheets if necessary. Omission of prior employment may be considered falsification of information.
Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE DO
NOT COMPLETE THIS INFORMATION WITH THE NOTATIONN “SEE RESUME.”
PLEASE NOTE: Township of Downe reserves the right to contact all current and former employers for
reference information.
Dates Employed (most recent
position)
From: To
Full time
Part-time
If part-time, # hrs./wk:
Title:
Starting Salary:
Organization Name and Address:
Final Salary:
Supervisor’s Name, Title and Phone
#:
Other Reference Name, Title and
Phone #:
Contact my current references:
At any time
Only if I am a finalist candidate
Primary duties:
Reason for Leaving:
Dates Employed (most recent
position)
From: To
Full time
Part-time
If part-time, # hrs./wk:
Title:
Starting Salary:
Organization Name and Address:
Final Salary:
Supervisor’s Name, Title and Phone
#:
Other Reference Name, Title and
Phone #:
Contact my current references:
At any time
Only if I am a finalist candidate
Primary duties:
Reason for Leaving:
Dates Employed (most recent
position)
From: To
Full time
Part-time
If part-time, # hrs./wk:
Title:
Starting Salary:
Organization Name and Address:
Final Salary:
Supervisor’s Name, Title and Phone
#:
Other Reference Name, Title and
Phone #:
Contact my current references:
At any time
Only if I am a finalist candidate
Primary duties:
Reason for Leaving:
PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.
I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully
complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after
employment if discovered at a later date. I authorize Township of Downe to investigate, without liability, all statements contained in this application and
supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this
application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal
substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if
tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of Township of Downe serve at-will,
and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I
will be required to furnish proof of eligibility to work in the United States and to comply with company and departmental regulations.
Applicant Signature: _______________________________________
Date: ________________
VOLUNTARY AFFIRMATIVE ACTION INFORMATION
You are not required to provide this information. Provide only if you wish. If you provide information on this
page, it will be filed separately from the job application. This information will be used only for purposes of the
affirmative action program.
Name:
Address:
City/Town:
Phone:
Position Applied For:
How did you learn about this employment opportunity? Check all that apply:
Ad in newspaper
Job Bulletin (Posting)/Walk-in
Website
Dept. of Labor
Referral by employee Other:
INFORMATION REGARDING STATUS:
Gender
Male
Female
Equal Employment Opportunity Identification Groups:
White
African American (non Hispanic)
Hispanic
American Indian/Alaskan Native
Asian/Pacific Islander
Other
Other protected Groups:
Individual with a disability
Vietnam-era veteran (served between 1964-1975)
Disabled veteran
COMMENTS: