Apply for Employment

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Executive Summary

This document is an application for employment with the Borough of Westville. It collects standard applicant information such as contact details, work history, education, skills, and references. Applicants are required to authorize the investigation of statements made in the application and acknowledge that any employment relationship is 'at will'.

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--- Document: Apply for Employment Document ---
APPLICATION FOR EMPLOYMENT
(Please Print) 
Position(s) Applied For 
Date of Application 
How Did You Learn About Us? 
Relative 
Facebook
Advertisement
Web Site
Friend 
 Other: 
Last Name 
First Name 
Middle Name 
Address 
City 
State 
Zip Code 
Telephone Number(s) 
Social Security Number 
Best time to contact you is: ...................……………………………………………..…__________:________AM/PM
If you are under 18 years of age, can you provide required 
proof of your eligibility to work? ………………….…………………………………………………….. ☐  Yes  ☐  No 
Have you ever filed an application with us before? ………………………………………………….  ☐  Yes  ☐  No 
If yes, give date _____________ 
Have you ever been employed with us before? ………………………………………….…… …….. ☐  Yes  ☐  No 
If yes, give date _____________ 
Do any of your friends or relatives, other than spouse, work here? ……………………………….. ☐  Yes  ☐  No 
Are you currently employed?........................................................... ……………………………….. ☐  Yes  ☐  No 
May we contact your present employer?......................................................................................  ☐  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 upon employment) ………………….. ☐  Yes  ☐  No 
Date available for work ____/____/____          What is your desired salary range? _______________________ 
Are you available to work: ____ Full- Time (please indicate 1,  2, 3 shift) ______________________________ 
  ____ Part-Time (please indicate  ___ Mornings ___ Afternoons ___ Evenings) 
  _____ Temporary (please indicate dates available (____________ to ____________) 
Are you currently on “lay-off” status and subject to recall? ………………………………………… ☐  Yes  ☐  No 
Can you travel if a job requires it? …………………………………………………………………….. ☐  Yes  ☐  No 
WE ARE AN EQUAL OPPORTUNITY EMPLOYER 
We consider applicants for all positions without regard to race, color, religion, creed, gender, 
national origin, age, disability, marital or veteran status, or any other legally protected status. 
Borough of Westville
165 Broadway, Westville, NJ  08093


Application For Employment 
Name and Address 
of School 
Course of Study 
Years 
Completed 
Diploma 
Degree 
High School
College
Other 
(Specify) 
Describe any specialized training, apprenticeship, skills and extra curricular activities. 
Describe any job-related training received in the United States military. 


Employment Experience 
1. 
2. 
3. 
4. 
If you need additional space, please continue on a separate sheet of paper. 
Start with your represent or last job. Include any job-related military service assignments and volunteer 
activities. You may exclude organizations which indicate race, color, religion, gender, national origin, dis- 
abilities or other protected status. 
List professional, trade, business, or civic activities and offices held. 
You may exclude membership which would revel gender, race, religion, national origin, age, ancestry, disability or other 
protected status: 
Employer 
Dates Employed 
Work Performed 
From 
To 
Address 
City, State 
Telephone Number 
Job Title 
Supervisor 
Reason for Leaving 
Employer 
Dates Employed 
Work Performed 
From 
To 
Address 
City, State 
Telephone Number 
Job Title 
Supervisor 
Reason for Leaving 
Employer 
Dates Employed 
Work Performed 
From 
To 
Address 
City, State 
Telephone Number 
Job Title 
Supervisor 
Reason for Leaving 
Employer 
Dates Employed 
Work Performed 
From 
To 
Address 
City, State 
Telephone Number 
Job Title 
Supervisor 
Reason for Leaving 


____________________________________________________________________________ 
Summarize special job-related skills and qualifications acquired from employment or other experience. 
Other Qualifications 
Additional Information 
Specialized Skills (List Skills/Equipment Operated) e.g. CDL license or SLEO II
References 
 1. 
( 
)  
(Name) 
(Phone#) 
(Address) 
 2. 
( 
)  
(Name) 
(Phone#) 
(Address) 
 3. 
( 
)  
(Name) 
(Phone#) 
(Address) 
State any additional information you feel may be helpful to us in considering your application. 
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN 
INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING. 
Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, 
the activities involved in the job or occupation for which you have applied? A review of the activities 
involved in such a job or occupation has been given. 
 
Yes 
 
No 


Applicant’s Statement 
    I certify that answers given herein are true and complete. 
I authorize investigation of all statements contained in this application for employment as may be 
necessary in arriving at an employment decision. 
This application for employment shall be considered active for a period of time not to exceed 45 
days. Any applicant wishing to be considered for employment beyond this time period should inquire 
as to whether or not applications are being accepted at that time. 
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employ- 
ment relationship with this organization is of an “at will” nature, which means that the Employee may 
resign at any time and the Employer may discharge Employee at any time with or without cause. It  
is further understood that this “at will” employment relationship may not be changed by any written 
document or by conduct unless such change is specifically acknowledged in writing by an author- 
ized executive of this organization. 
In the event of employment, I understand that false or misleading information given in my applica- 
tion or interview(s) may result in discharge. I understand, also, that I am required to abide by all 
rules and regulations of the employer. 
Signature of Applicant 
Date 
For Borough of Westville Use Only
Arrange Interview: 
□Yes
□No
Remarks: 
Interviewer 
Date 
Employed: 
□Yes
□No
Date of Employment:  
Hourly Rate/ 
Job Title: 
Salary:  
Department: 
By: 
Name and Title 
Date 
Position(s) Applied For Is Open: 
□Yes
□No
Position(s) Considered For: 
Date: 


PERSONAL INFORMATION RELEASE 
I, 
, reside at 
Print Full Name 
Print Full Address 
State 
Zip Code 
City 
I do hereby authorize the Borough of Westville to obtain any information from schools,
residential management agents, employers, criminal justice agencies, personal physicians, or 
individuals, relating to my activities. This information may include, but is not limited to, 
academic, residential, achievement performance, attendance, personal history, disciplinary, 
arrest and conviction records (both adult & juvenile), and all medical records. 
I do hereby direct you to release such information upon request of the bearer. I understand that 
the information released is for the Borough's  use only.
I hereby release any individual, including Record Custodians, from any and all liability for 
damages of whatever kind or nature which may at any time result to be on account of compliance 
or any attempts to comply with this authorization. 
Signature of Applicant 
Date: