Application
for Employment
Directions: Fill out online and print out the forms. Mail
to PO Box 1123, Westborough, MA 01581 or deliver to 45 West Main Street,
Westborough, MA.
Date:
Position(s) Applied for:
Referral Source:
Advertisement
Friend
Relative
Walk In
Other
Name:
Address:
Town:
State:
Zip:
Social Security Number:
Telephone:
Other Phone:
Have you ever been employed here before?
Yes
No
If Yes, please give dates for employment:
Can you upon employment submit verification of you legal right
to work in the United States?
Yes
No
On what date would you be available for work?
Are you available to work:
Full Time
Part Time
Shift Work
Temporary
Are you on a lay-off and subject to recall?
Yes
No
Can you travel if the job requires it?
Yes
No
Please enter any additional information you would like considered:
Please give the names, address and telephone numbers of three
(3) references who are not related to you and are no previous employers:
1. Name:
Full Address:
Phone Number:
2. Name:
Full Address:
Phone Number:
3. Name:
Full Address
Phone Number:
Employment Experience:
Start with you present or last job. You may include verified
work performed on a voluntary basis. Exclude organizations names which indicate
race, color, religion, sex or national origin.
Employer:
Address:
Town:
State:
Zip Code:
Country:
Job Title:
Supervisor:
Reason for Leaving:
Dates Employed:
Hourly Rate / Salary:
Employer:
Address:
Town:
State:
Zip Code:
Country:
Job Title:
Supervisor:
Reason for Leaving:
Dates Employed:
Hourly Rate / Salary:
Employer:
Address:
Town:
State:
Zip Code:
Country:
Job Title:
Supervisor:
Reason for Leaving:
Dates Employed:
Hourly Rate / Salary:
Employer:
Address:
Town:
State:
Zip Code:
Country:
Job Title:
Supervisor:
Reason for Leaving:
Dates Employed:
Hourly Rate / Salary:
Employer:
Address:
Town:
State:
Zip Code:
Country:
Job Title:
Supervisor:
Reason for Leaving:
Dates Employed:
Hourly Rate / Salary:
Education: (See job description for educational
requirements necessary for position)
Name of Elementary School:
Full Address:
Name of High School:
Full Address:
G.E.D.:
Yes
Name of Undergraduate College:
Full Address:
Course of Study:
Diploma Degree:
Name of other School/Military (Graduate, J.D., Medical, ect.)
Full Address:
Describe specialized training, apprenticeship, skills and
extra-curricular activities if relevant to this position:
Describe any job-related training received in the United States Military:
Disclosures
It is unlawful in Massachusetts to require or administer a
lie detector test as a condition of employment or continued employment.
An employer who violates this law shall be subject to criminal penalties
and civil liabilities.
The Town does not discriminate in employment on the basis
of race, color, religion, sex, sexual orientation, handicap or national
origin.
Your appointment may be subject to a physical examination
relating to the essential functions of the job.
Applicant's Statement
I certify that answers given herein are true and complete
to the best of my knowledge.
I authorize investigation of all statements contained in these
application for employment as may be necessary in arriving at an employment
decision.
I hereby understand and acknowledge that unless otherwise
defined by applicable law, any employee relationship with the Town of Westborough
is of an "at will" nature, which means that the Employee may resign
at any time and the Employer may discharge Employee at any time, with or
without cause. It is further understood that this "at will" employment
relationship may not be changed by any written document or by conduct unless
such change is specifically acknowledged in writing by an authorized executive
of the Town of Westborough.
My purpose in filling out this application is to obtain the
job for which I am applying, and I am available and willing to accept the
position if it is offered to me.
In the event of employment, I understand that false or misleading
information given in my application or interview(s) my result in discharge.
I understand also, that I am required to abide by all rules and regulations
of the Employer.
Signature of Applicant:____________________________
Date:____________