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Personal Information

First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Position you're applying for
Date you can begin work
Date you can begin work
Date you can begin work
Salary desired
How did you hear about this position?
Are you available for (check all that apply)
1. Full-time
2. Part-time
3. Temporary
4. Shift Work
Are you currently employed?
1. Yes
2. No
May we contact your current employer?
1. Yes
2. No
3. Does not apply
Have you ever applied to Franklin Township before?
1. Yes
2. No
If "yes," provide the date
If "yes," provide the date
If "yes," provide the date
Are you laid off, subject to recall?
1. Yes
2. No
Do you possess a current drivers' license?
1. Yes
2. No
Do you possess a commercial drivers' license?
1. Yes
2. No
If "yes," list endorsements
Have you ever been convicted of a violation of the law other than a minor traffic violation?*
1. Yes
1. No
Employment is conditional upon the results of a criminal background check. An answer of “yes” may disqualify you from employment, depending upon the circumstances involved.
If you answered "yes," please explain.
Are you eligible to work in the United States?*
1. Yes
1. No
Pursuant to Federal law, proof of citizenship or immigration status will be required if you are hired.
If you are under 18 years old, do you have proof of eligibility to work?
1. Yes
2. No
Which languages do you speak/read, and how fluent are you?
Special Skills
List any special skills, experience, training, licenses, certifications or other factors that make you especially qualified for the position for which you are applying.
Comments & Additional Information
Is there any additional information about you that we should consider?
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Education

High School
Address
Graduated
1. Yes
2. No
College
Address
Degree
Other
Address
Degree
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Employment History

(From Most Recent)
This section must be completed, even if you attach a resume. List your last three employers, major assignments for the same employer. Begin with the most recent. Include any military service. Explain any gaps in employment in the space on this form marked “Comments,” located at the end of this section.
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
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References

Please list three professional references.
Full Name*
Relationship*
Company*
Phone Number*
Full Name*
Relationship*
Company*
Phone Number*
Full Name*
Relationship*
Company*
Phone Number*
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Disclaimer & Signature

Understandings and Agreements: As an applicant for a position with the Township of Franklin, 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 that I may be separated from employment if the Township of Franklin later discovers that information on this form was incomplete, untrue, or inaccurate. I give the Township of Franklin the right to investigate the information I have provided, talk with former employers (except where I have indicated they may not be contacted). I give the Township of Franklin the right to secure additional job-related information about me. I release the Township of Franklin and its representatives from all liability for seeking such information. I understand that the Township of Franklin is an equal opportunity employer and does not discriminate in its hiring practices. I understand that the Township of Franklin will make reasonable accommodations as required by the Americans with Disabilities Act. I understand that, if employed, I may resign at any time, and that the Township of Franklin may terminate me at any time in accordance with its established policies and procedures. No representatives of the Township of Franklin may make any assurances to the contrary. I understand that any offer of employment may be subject to job-related medical physical, drug or psychological tests. I also understand that some positions may involve complete background and criminal checks. For your application to be considered, you must sign and date below.
Applicant Signature*

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