Employment Application

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FAILURE TO LEGIBLY COMPLETE THE ENTIRE APPLICATION MAY PREVENT THE TOWN FROM REVIEWING / PROCESSING YOUR APPLICATION.

THE TOWN OF GREECE DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, SEX, SEXUAL ORIENTATION, MARITAL STATUS, RELIGION, CREED, AGE, NON-DISQUALIFYING DISABILITY, OR ANY OTHER LEGALLY PROTECTED CLASSIFICATION WHEN CONSIDERING INDIVIDUALS FOR EMPLOYMENT.

Your Information

First Name*

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Middle Name

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Last Name*

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Phone Number*

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Email Address*

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Address*

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Address 2

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City*

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State*

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Zip Code*

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Employment History

Have you ever worked for the Town of Greece?*

YesNo

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Dates Worked*

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Job Title*

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Department*

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Please describe in detail your previous experience, including military experience. Begin with your current or most recent employment.

Employer 1

Start Date*

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End Date*

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Employer*

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Job Title*

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Hours per week worked*

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Description of Duties*

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Reason for Leaving*

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Employer 2

Start Date

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End Date

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Employer

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Job Title

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Hours per week worked

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Description of Duties

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Reason for Leaving

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Employer 3

Start Date

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End Date

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Employer

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Job Title

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Hours per week worked

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Description of Duties

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Reason for Leaving

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U.S. Military Service

Branch

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Rank Upon Discharge

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Nature of Discharge

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Education

High School

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Location

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Number of Years Attended

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Degree / Major

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College, Trade, or Business School

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Location

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Number of Years Attended

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Degree / Major

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Graduate School

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Location

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Number of Years Attended

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Degree / Major

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Reference Information

Please state name and relationship

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Please provide the names of three persons, NOT related to you, at least one of which is a former employer.

Reference 1

Name*

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Address*

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Phone Number*

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Business / Relationship*

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Reference 2

Name*

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Address*

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Phone Number*

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Business / Relationship*

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Reference 3

Name*

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Address*

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Phone Number*

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Business / Relationship*

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I certify that the information set forth on this application is true and complete. I authorize the Town of Greece to make inquiries and verify information, as may be necessary to arrive at an employment decision. This may include verification and inquiries into my personal, employment or educational history, from whatever source and method. This inquiry includes but is not limited to verification and inquiries into the information set forth in my original application or any amendments thereto, attendance and performance records from school and prior employment, of my school records and transcripts, employment and school records relating to any disciplinary action or termination of employment, and information concerning my character, integrity, and capabilities.

I further authorize the release of criminal history information, including any supporting documents or materials, to the Town of Greece. I understand that false, misleading, or incomplete information given on this application or in any employment interview may result in disqualification from further consideration, or if employed by the Town, in discharge.

Signature*

Sign Above

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Date*

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