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Town of
Dewey Beach
Employment Application - General
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W10=
*
Full Name
*
Nickname, Alias, Maiden Name (Specify)
*
Position Applied For
*
Residence Address (Street, City, State, Zip)
*
Phone
*
Email
Driver's License Number, Class & State
Are you currently employed?
Are you currently employed?
Yes
No
May we contact your employer?
May we contact your employer?
Yes
No
Current Employer 1
Position
Employer Phone
Current Employer 2
Position
Employer Phone
If employed and you are under 18, can you furnish a work permit?
If employed and you are under 18, can you furnish a work permit?
Yes
No
Have you every applied for employment with the Town of Dewey Beach?
Have you every applied for employment with the Town of Dewey Beach?
Yes
No
Have you ever been employed with the Town of Dewey Beach?
Have you ever been employed with the Town of Dewey Beach?
Yes
No
Are you legally able to work in the U.S. (proof may be required upon employment)?
Are you legally able to work in the U.S. (proof may be required upon employment)?
Yes
No
Do you have a valid driver's license (required for driving jobs)?
Do you have a valid driver's license (required for driving jobs)?
Yes
No
If hired, do you expect to be engaged in any additional business or employment elsewhere?
If hired, do you expect to be engaged in any additional business or employment elsewhere?
Yes
No
If yes to above, please describe
Do you speak/write/read a foreign language?
Do you speak/write/read a foreign language?
Yes
No
If yes to above, which language(s)?
Have you ever been fired from a job or asked to resign?
Have you ever been fired from a job or asked to resign?
Yes
No
If yes to above, please explain
Have you worked or attended school by any other name than listed above?
Have you worked or attended school by any other name than listed above?
Yes
No
If yes to above, provide names
Employment History
Employer
Employer Phone
Position
Length of Employment
Supervisor Name
Reason for Leaving
Employer
Employer Phone
Position
Length of Employment
Supervisor Name
Reason for Leaving
Education
College
City, State
Number of Years Completed
Highest Grade/Diploma/Degree Earned
High School
City, State
Number of Years Completed
Highest Grade/Diploma/Degree Earned
Other Institution
City, State
Certification Earned
Skills and Experience
List professional, trade, business or civic activities and offices held
(exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability or other protected status)
What skills or additional training do you have that relate to the job for which you are applying?
What machines or equipment can you operate that are related to the job for which you are applying?
Attach resume, letters of recommendation or other documentation here
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References
List three personal references, not including relatives or former employers
Reference 1
Relationship
Phone
Years of Acquaintance
Reference 2
Relationship
Phone
Years of Acquaintance
Reference 3
Relationship
Phone
Years of Acquaintance
Employment Agreement
Signature
I certify that all information provided in this employment application is true and complete. I understand that any false information or omissions may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand I may be required to successfully pass a drug screen examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any for all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. I understand that this application, verbal statements by management, or subsequent employment does not create an express or implied contract of employment nor guarantee employment for any definite period of time. Only the president of the organization has the authority to enter into an agreement of employment for a specified period and such agreement must be in writing, signed by the Town Manager, and the employee. If employed, I understand that I have been hired at the will of the employer and my employment may be terminated at any time, with or without reason and with or without notice. I have read, understand, and by my signature consent to these statements.
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