Instructions

This application will be used as part of the examination process, so it is important that you complete all sections of this application completely and accurately. Incomplete applications will not be considered. Applications must be submitted by the posted closing date in order to ensure consideration.

Current Information

Position Applied for:*

Date: *

When are you available for employment?*

Are you seeking: *

Full-Time

Part-Time

Last Name:*

First Name:*

Middle Name:*

Address:*

City*

State:*

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Zip Code:*

Home Telephone:*

Business Telephone:*

Email Address:*

Are you 18 or older?*

Yes

No

If no, what is your birth date?

General Information

Have you ever been employed with the Town of Morrisville?*

Yes

No

If yes, what department and when?

Have you previously applied for employment with the Town of Morrisville?*

Yes

No

If yes, indicate what position and when?

Are you now or were you previously related in any way to a Town employee?*

Yes

No

If yes, provide the name, relationship, and department.

Are you able to perform all of the duties of the job for which you are applying?*

Yes

No

Are you a veteran of war, spouse of a veteran of war, or dependent of a veteran of war?*

Yes

No

If yes, please complete the Veterans section below.

Have you ever been convicted of a felony or misdemeanor requiring imprisonment or a fine in excess of $50?*

Yes

No

If yes, please explain.

Note: The existence of a criminal record does not automatically eliminate you from employment consideration. Factors such as age at time of offense, rehabilitation efforts, length of time since offense, and nature of the crime will be taken into consideration.

Are you an American citizen or do you currently have authorization to work in the U.S.?*

Yes

No

Did you receive any of your education or employment experience under another name?*

Yes

No

If yes, please explain.

Education

High School

Indicate the highest school year completed (8, 12, 16, etc.):*

Have you received a high school diploma or equivalent?*

Yes

No

Name of High School:*

City:*

State:*

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

College and/or University

Name(s) and Location(s):

Attended from Mo/Yr - Mo/Yr:

Did you graduate?

Yes

No

Degree, Diploma, Certificate Earned, or Number of Years:

Credit Hours:

Major / Minor:

Graduate and/or Professional Schools

Name(s) and Location(s):

Attended from Mo/Yr - Mo/Yr:

Did you graduate?

Yes

No

Degree, Diploma, Certificate Earned, or Number of Years:

Credit Hours:

Major / Minor:

Technical Institutes, Internships, Other

Name(s) and Location(s):

Attended from Mo/Yr - Mo/Yr:

Did you graduate?

Yes

No

Degree, Diploma, Certificate Earned, or Number of Years:

Credit Hours:

Major / Minor:

Knowledge, Skills, and Abilities

Please list any knowledge, skills, or abilities you have that are applicable to the position for which you are applying. Include skills with equipment or machines you can operate. If you are applying for a clerical position, indicate typing speed and software packages known and/or used.

List here:*

Registrations, Licenses, and Certifications

List fields of work for which you have been registered, licensed, or certified.

Registration:

State:

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Number:

Exp. Date:

Registration:

State:

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Number:

Exp. Date:

Other:

List your valid driver's license number and state in which it was issued. If you do not have a driver's license, indicate none.

Number:*

State:*

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Is your driver's license a Commercial Driver's License (CDL)?*

Yes

No

If yes, indicate class:

Employment

Record your complete work history in the spaces below. Begin with your current or most recent position. Include military and related volunteer experience. Be certain to account for gaps in your employment history. All spaces must be completed or marked n/a (not applicable). You are welcome to attach a resume, however "see attached resume" is not acceptable in the space provided for description of duties.

Current or Most Recent Employment (or Explain Gap in Employment)

Job Title:

Starting Salary:

Last Salary:

Employer or Company:

Date Employed:

Date Separated:

Employer or Company Address:

Telephone Number:

Name and Title of Current Supervisor:

Full-Time (yrs., mos.)

Part-Time (yrs., mos.)

# employees supervised by you:

If part-time, the number of hours worked per week:

Duties in order of importance:

Reason for Leaving:

Next Most Recent Employment (or Explain Gap in Employment)

Job Title:

Starting Salary:

Last Salary:

Employer or Company:

Date Employed:

Date Separated:

Employer or Company Address:

Telephone Number:

Name and Title of Current Supervisor:

Full-Time (yrs., mos.)

Part-Time (yrs., mos.)

# employees supervised by you:

If part-time, the number of hours worked per week:

Duties in order of importance:

Reason for Leaving:

Next Most Recent Employment (or Explain Gap in Employment)

Job Title:

Starting Salary:

Last Salary:

Employer or Company:

Date Employed:

Date Separated:

Employer or Company Address:

Telephone Number:

Name and Title of Current Supervisor:

Full-Time (yrs., mos.)

Part-Time (yrs., mos.)

# employees supervised by you:

If part-time, the number of hours worked per week:

Duties in order of importance:

Reason for Leaving:

Next Most Recent Employment (or Explain Gap in Employment)

Job Title:

Starting Salary:

Last Salary:

Employer or Company:

Date Employed:

Date Separated:

Employer or Company Address:

Telephone Number:

Name and Title of Current Supervisor:

Full-Time (yrs., mos.)

Part-Time (yrs., mos.)

# employees supervised by you:

If part-time, the number of hours worked per week:

Duties in order of importance:

Reason for Leaving:

Next Most Recent Employment (or Explain Gap in Employment)

Job Title:

Starting Salary:

Last Salary:

Employer or Company:

Date Employed:

Date Separated:

Employer or Company Address:

Telephone Number:

Name and Title of Current Supervisor:

Full-Time (yrs., mos.)

Part-Time (yrs., mos.)

# employees supervised by you:

If part-time, the number of hours worked per week:

Duties in order of importance:

Reason for Leaving:

More Information

Have you had disciplinary action taken against you in the past 12 months?*

Yes

No

If yes, please explain.

Have you even been dismissed or forced to resign from any job held?*

Yes

No

If yes, please explain.

Were you dismissed or forced to resign for disciplinary reasons?*

Yes

No

If yes, please explain.

If you are currently employed, may we contact your present employer for a reference prior to an interview (if granted)?*

Yes

No

If yes, please explain.

ATTENTION: Please read the following instructions regarding resumes

Resumes should be attached as a .PDF (Adobe) document and titled as follows:

Last name, First Initial. Resume (ex: Smith, J. Resume)

If unable to load as PDF, Word Documents will also be acceptable.

Attach a Resume

Certification and Release

• To the best of my knowledge and belief, the information given truly represents my background and experience. I understand that if I have knowingly or negligently misrepresented, falsified, or omitted any information during the application process, or have made any changes to the format or wording of this application form, I may be disqualified for employment consideration or dismissed from employment with the Town.
• I authorize my current and former employers to give any information regarding me or my employment, whether or not it is in their records. I hereby release them from any damage whatsoever for issuing same.
• I authorize educational institutions that I attended to reveal my scholastic ratings, as well as degrees or certificates earned, to the Town of Morrisville, and associations, registration, and licensing boards and others to furnish whatever detail is available concerning my qualifications. Notwithstanding any provision of state of federal law, I expressly waive any right I have to review information the Town receives from an employer or educational institution under a promise of confidentiality.
• I permit the Town of Morrisville to conduct a police, court, credit, and/or motor vehicle records investigation of my background.
• I understand that if I am offered employment with the Town of Morrisville, I will be tested for drug use. I consent to testing and understand that the results could preclude my employment.
• I understand and acknowledge that should the Town of Morrisville employ me, then I serve "at will". This means that I may be terminated at any time with or without cause. I further understand that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically approved by the Town Manager.

By typing your name in the box below, it is the equivalent of a signature.

Please Print a Copy of Your Application for Your Records.