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Step One

FOR OFFICE USE ONLY
Date Received: ______________________ Received By: ______________________
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Step Two

Equal Opportunity
The Borough of Hanover is an equal opportunity employer. We are dedicated to a policy of non-discrimination employment on any basis protected by law including race, creed, color, age, gender, national original, or physical handicap.
Please complete all the requested information. Statements regarding education, employment, etc. and all references are subject to investigation and verification. False statements may lead to discipline and/or termination if discovered after employment. A resume may be attached, but should not replace the information requested on this form.
Full Name
Today's Date
Today's Date
Permanant Address (No P.O. Boxes)
City
State
Zip Code
Local Address (if Different from Permanent)
City
State
Zip Code
Phone Number
Mobile Number
Email Address
Are you legally permitted to work in the United States?
1. Yes
2. No
Position Desired
Salary Desired
Date You Can Start
Date You Can Start
Type
1. Full-Time
2. Part-Time
3. Seasonal
Are you employed now?
1. Yes
2. No
Are you available on weekends?
1. Yes
2. No
Any disabilities that would prevent you from performing the duties of the job or any ADA accommodation that we should know about?
1. Yes
2. No
If yes, please explain
Certifications and Skills: Please bring proof of certification to your interview(s).
1. Carpentry
2. CDL - Class A
3. CDL - Class B
4. CPR
1. First Aid
2. Heavy Equipment Operator
3. Masonry
4. Metal Works
Other Certification or Skills
List any relatives and/or family or friends currently employed by the Borough of Hanover:
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Education

High School
Years Attended
City
State
Zip Code
Major Courses
College
Years Attended
City
State
Zip Code
Tech School
Years Attended
City
State
Zip Code
Grad School
Years Attended
City
State
Zip Code
Other
Years Attended
City
State
Zip Code
List any additional skills or certifications you have
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Work History: List the last four employers, starting with the present or most recent

Name
Date
Date Start Date
—
Date End Date
Address
City
State
Zip Code
Salary
Position
Phone
Supervisor
May we contact?
1. Yes
2. No
Reason for Leaving
Name
Date
Date Start Date
—
Date End Date
Address
City
State
Zip Code
Salary
Position
Phone
Supervisor
May we contact?
1. Yes
2. No
Reason for Leaving
Name
Date
Date Start Date
—
Date End Date
Address
City
State
Zip Code
Salary
Position
Phone
Supervisor
May we contact?
1. Yes
2. No
Reason for Leaving
Name
Date
Date Start Date
—
Date End Date
Address
City
State
Zip Code
Salary
Position
Phone
Supervisor
May we contact?
1. Yes
2. No
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Military Experience

Branch of Service
Are you a veteran?
1. Yes
2. No
Dates (month/year) of Military Service (Active and Reserve)
Type of Discharge
List Military Awards
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References

List three persons not related to you and not listed as previous employers. These references should be familiar with your background and character.
Name
Occupation
Address
City
State
Zip Code
Phone
Name
Occupation
Address
City
State
Zip Code
Phone
Name
Occupation
Address
City
State
Zip Code
Phone
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Miscellaneous

List any activities or special award
List any subjects of special study or research
List any other special training(s) you may have
Upload Resume
(Optional)
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Emergency Contact Information

Name
Phone
Address
City
State
Zip Code
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Step Nine

I authorize investigation of all statements made in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. I also authorize a criminal background investigation of myself - this includes a background investigation of my driving history. Further, I understand and agree that my employment is for no definite period and may, at the discretion of the employer, be terminated at any time without any previous notice, subject to terms and conditions of any bargaining unit agreements with the Borough of Hanover (if the employee is covered by a bargaining unit).
1. Yes
2. No
I understand that the Borough of Hanover has a zero tolerance policy regarding substance abuse and has a stringent drug/alcohol policy in place. I understand that all job applicants and/or new employees may be required to comply with drug testing protocols as outlined by law. Such tests may be required without prior notification and may be requested at random with cause for the presence of alcohol and/or drugs in my body. I acknowledge that a confirmed positive test may cause me not to be hired or to be removed from the payroll and subject to discipline up to and including termination, or with a recommendation to attend a drug/alcohol rehabilitation program. I fully understand that if I should refuse to take the test, I will not be hired, or I could be suspended from my job without pay or be terminated for insubordination. I also understand that the test results will be held in confidence and handled by authorized management personnel.
1. I hereby consent
2. I hereby refuse
I acknowledge that this document (or any accompanying document executed or delivered pursuant to or in connection with the drug/alcoholpolicy is not intended to confer any contractural or other rights or claims in my favor (and that I remain employed at will).
1. Yes
2. No
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To be completed by parent or guardian of minor children.

I give consent to the investigation and drug/alcohol testing outlined in this employment application of my child.
1. Yes
2. No

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Search Forms:

Application for Employment or Volunteer Service

Steps

Step One

Step Two

Education

Work History: List the last four employers, starting with the present or most recent

Military Experience

References

Miscellaneous

Emergency Contact Information

Step Nine

To be completed by parent or guardian of minor children.