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:____________