Area of Interest

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• Position Applying For*

• Date*

• Type*:

•  Full-time
•  Part-time
•  Seasonal

• Department*:

•  General Government
•  Welfare Services
•  Mental Health Board
•  Community Health

•  Assessor's Office
•  Highway Department
•  Youth and Family Services
•  Veterans Affairs

•  Clerk's Office
•  Maintenance Department
•  Senior Services
•  Emergency Management

Personal Information

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• Your Last Name*

• Your First Name*

• Middle Name*

 

• Present Street Address*

• City*

• State*

• Zip Code*

 

• Home Phone Number*

• Work Phone Number*

• Cell Phone Number*

• Are you at least 18 years of age?*

•  Yes

•  No

 

• If the job for which you are applying requires a driver's license, can you provide proof of possessing a valid license?*

•  Yes

•  No

 

• If the job requires a commercial driver's license (CDL), do you have one?*

•  Yes

•  No

 

• Are you lawfully permitted to become employed in this country?* (Proof of eligibility shall be required within three (3) days of the date of hire)

•  Yes

•  No

 

• Have you ever been convicted of a felony?*
  (The inquiry as to whether you have been convicted of a crime does not require you to disclose, verbally or in writing any record of a conviction or arrest that has been expunged or sealed. Criminal convictions are not an absolute bar to employment.)

•  Yes

•  No

• If the answer was yes, please provide details below:

Availability

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• Please list days and hours you are available to work*

• Your wage requirements*

• Earliest date you can begin*

• Are you currently employed?*

•  Yes

•  No

 

• May we contact your present employer?*

•  Yes

•  No

 

• Have you previously worked for the Township?*

•  Yes

•  No

 

• If "Yes," please identify your:

• Start Date (month/year)

• Separation Date (month/year)

• Job Title at time of separation

• Reason for Leaving

Employment History

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• Employer*

• Employer Phone Number*

 

• Employer Address*

• City*

• State*

• Zip Code*

 

• Your Job Title*

• Start Date*

• Separation Date*

• Description of work performed*

• Manager's Name and Title*

• Hours/Week*

• Last Wage*

• Reason for Leaving or Looking for a New Position*

---

• Employer

• Employer Phone Number

 

• Employer Address

• City

• State

• Zip Code

 

• Your Job Title

• Start Date

• Separation Date

• Description of work performed

• Manager's Name and Title

• Hours/Week

• Last Wage

• Reason for Leaving or Looking for a New Position

---

• Employer

• Employer Phone Number

 

• Employer Address

• City

• State

• Zip Code

 

• Your Job Title

• Start Date

• Separation Date

• Description of work performed

• Manager's Name and Title

• Hours/Week

• Last Wage

• Reason for Leaving or Looking for a New Position

Education Information

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•  

• School name and location

• Number of years attended

• Major field of study

• Did you graduate?

 

• High School

•  Yes

•  No

 

• College/University

•  Yes

•  No

 

• College/University

•  Yes

•  No

 

• Graduate School

•  Yes

•  No

 

• Trade School/Other

•  Yes

•  No

• Please list below any special job-related skills, training, experiences, licenses, professional associations or certificates you posses.*

References

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• List below two persons not related to you, whom you have known through your employment for at least one year:

• Name*

• Position/Job Title*

 

• Daytime or Business Phone*

• Home Phone*

• Years Known*

---

• Name

• Position/Job Title

 

• Daytime or Business Phone

• Home Phone

• Years Known

---

• Name

• Position/Job Title

 

• Daytime or Business Phone

• Home Phone

• Years Known

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• If you are a veteran of the U.S. Military Service, please describe below any skills or job-related training acquired while serving:

• Why do you want to work for Hanover Township?*

• I, the undersigned, certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, any misstatement or omission of information on this application or at any time during the selection process may be grounds for dismissal.
• I authorize the investigation of all statements contained herein and information concerning my previous employment and any other pertinent information, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
• In addition, I understand that, if selected for employment, I may have to successfully pass a physical examination and/or drug screen performed by a medical professional selected and paid for by Hanover Township and/or undergo employment verification and criminal background check, prior to starting employment.
• All employees of Hanover Township are employed "at will" and such employment can be terminated at any time, with or without cause, and with or without notice, at the option of either the Township or me.

• All new employees with the Township will receive a copy of the Personnel Policy Manual. The information in the manual may be changed at any time. The policy manual is not a contract of employment nor does it create any vested additional rights in any policy listed or benefit therein.