TOWNSHIP OF CHESTER 1 Parker Road Chester, NJ 07930 908-879-5100 www. chestertownship.org

Employment Application APPLICANT INFORMATION Last Name

First

M.I.

Number of years at current address

Street Address City

State

Phone Date Available

ZIP

E-mail Address Social Security No.

Desired Salary

Position Applied for Are you a citizen of the United States? Have you ever worked for Chester Township Have you ever worked for any other Municipality

Full Time YES

NO

If no, are you authorized to work in the U.S.?

YES

NO

If so, when?

YES

NO

If so, when?

Do you possess a driver’s license?

YES

NO

Do you possess a commercial driver’s license? (CDL)

YES

NO

Do you have any relatives currently working for Chester Township

YES

NO

DL # CDL #

REFERENCES Please list three professional references. Full Name

Relationship

Company

Phone

(

)

Address Full Name

Relationship

Company

Phone

(

)

Address Full Name

Relationship

Company

Phone

Address

Date

(

)

Part Time YES

NO

EDUCATION High School From

Address To

Did you graduate?

College From

NO

Degree

NO

Degree

NO

Degree

Address To

Did you graduate?

Other From

YES

YES Address

To

Did you graduate?

YES

CURRENT EMPLOYMENT Company

Phone

Address

Supervisor

(

)

Current Salary $

Job Title Responsibilities From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

YES

NO

PREVIOUS EMPLOYMENT (PAST FIVE YEARS)

Company

Phone

Address

Supervisor

Job Title

Starting Salary

(

)

$

Ending Salary

$

Ending Salary

$

Responsibilities From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

YES

NO

Company

Phone

Address

Supervisor

Job Title

Starting Salary

$

Responsibilities From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

YES

NO

(

)

Do you possess any special skills, experience, training, licenses, or certifications that make you especially qualified for the position for which you are applying? ____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

As an applicant for a position with the Township of Chester, I understand and agree that I must provide truthful and accurate information in this application. I understand that my application may be rejected if any information is not complete, true and accurate. If hired, I understand I may be separated from employment if the Township of Chester later discovers that information on this form was incomplete, untrue or inaccurate. I give the Township of Chester the right to investigate the information I have provided and talk with former employers (except where I have indicated they may not be contacted). I give the Township of Chester the right to secure additional job-related information about me. I release the Township of Chester and its representatives from all liability for seeking such information. I understand that if employed, I will be employed as an at-will and that the Township of Chester may terminate me at any time in accordance with its established policies and procedures, with or without cause and with or without notice, except as may be provided by law or by applicable labor contract. No representatives of the Township of Chester may make any assurances to the contrary.

Applicants Signature: ____________________________________________ Date: ________________________________________________________

Chester Township is an equal opportunity employer

township of chester

TOWNSHIP OF CHESTER. 1 Parker Road. Chester, NJ 07930. 908-879-5100 www. chestertownship.org. Employment Application. APPLICANT INFORMATION.

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