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2. TOWNSHIP OF SPARTA EMPLOYMENT APPLICATION

   The township of Sparta is an equal opportunity employer and as such does not discriminate in employment practices based on sex, pregnancy, breastfeeding, sexual orientation, gender identity, domestic partnership/civil union status, military status, and genetic information.  

4. Position Applying For:*
5. Date of Application*
7. First & Last Name*
8. Email Address*
10. Address*
12. City*
13. State*
14. Zip Code*
16. Phone Number*
20. Can you, if hired, submit proof of the right to work in the U.S. ?*

    1. Yes
    2. No
22. Are you under 18 years of age?*

    1. Yes (I am under 18 years old.)
    2. No (I am 18 years old or over.)
24. Date available to start work?*
    Date available to start work?
26. Type of Employment?*
    -- Select One --Full TimePart TimeTemporary / Seasonal
28. Have you ever been employed by the Township of Sparta?*

    1. Yes
    2. No
30. If yes, when and in what position?
32. Are you currently employed?*

    1. Yes
    2. No
33. Are you currently on lay-off status and subject to recall?*

    1. Yes
    2. No
35. Do any of your relatives work for the Township of Sparta?*

    1. Yes
    2. No
37. If yes, please give name and department.
39. Do you require any accommodation from the Township to perform the essential functions of the job for which you have applied?*

    1. Yes
    2. No
41. If yes, please list the type of accommodation required:
43. If the position for which you are applying involves the handling of money, to the best of your knowledge, is there any reason why you cannot be bonded for the receipt and reconciliation of moneys?*

    1. Yes
    2. No
45. If a license, certificate or other authorization is required or related to the position for which you are applying, complete the following:
47. License:
48. Date Issue:
50. Issued By: (State or Other Authority)
52. License Number:
53. Location of Issuing Authority:
57. Please answer the following questions if the position for which you are applying for involves operating a township vehicle.
59. Do you have a valid driver's license?*

    1. Yes
    2. No
61. Do you currently hold a CDL license?

    1. Yes
    2. No
62. Are there currently any points against your license?

    1. Yes
    2. No
64. If yes, how many?
66. Do you have transportation to and from work?*

    1. Yes
    2. No
68. Have you had your driving privileges suspended or revoked in the last 5 years?*

    1. Yes
    2. No
70. If yes, what were the circumstances surrounding the suspension or revoking of your driving privileges?
74. EDUCATION

    (NOTE: Applicants may be required to provide proof of diploma, degrees, transcripts, licenses, certifications and registrations.)

76. ELEMENTARY SCHOOL
78. Name & Location of School*
80. Years Completed*
81. Major
82. Diploma/Degree
84. HIGH SCHOOL
86. Name & Location of School*
88. Years Completed*
89. Major
90. Diploma/Degree
92. COLLEGE/UNIVERSITY
94. Name & Location of School
96. Years Completed
97. Major
98. Diploma/Degree
100. OTHER
102. Name & Location of School
104. Years Completed
105. Major
107. Special Skills/Qualifications

     List all special skills you possess and machines or office equipment you can use, such as calculations, printing or graphics equipment, computer equipment, types of software and hardware, etc. and any skills which you feel particularly fit you for work in the position applied for:

111. REFERENCES (Not relatives)
113. Reference # 1: First and Last Name*
115. Address/Email Address*
117. Phone Number*
119. Reference #2: First and Last Name*
121. Address/Email Address*
123. Phone Number*
125. Reference #3: First and Last Name*
127. Address/Email Address*
129. Phone Number*
133. EMPLOYMENT HISTORY

     This information will be the official record of your employment history and must accurately reflect all significant duties performed.  Summaries of experience should clearly describe your qualifications.  Begin with your current or last position and work back to your first position.  

135. Employer # 1
137. Address/Email Address
139. Phone Number
140. Supervisor
142. Start Date
143. End Date
145. Job Title
147. Summary of Experience
149. Reason For Leaving
151. Employer # 2
153. Address/Email Address
155. Phone Number
156. Supervisor
158. Start Date
159. End Date
161. Job Title
163. Summary of Experience
165. Reason For Leaving
167. Employer # 3
169. Address/Email Address
171. Phone Number
172. Supervisor
174. Start Date
175. End Date
177. Job Title
179. Summary Of Experience
181. Reason For Leaving
183. Employer # 4
185. Address/Email Address
187. Phone Number
188. Supervisor
190. Start Date
191. End Date
193. Job Title
195. Summary Of Experience
197. Reason For Leaving
199. CERTIFICATION (Please read and sign below.)

     I certify that the information contained herein is true and complete.  I further understand that this application is not and is not intended to be a contract of employment, nor does this application obligate the employer in any way if the employer decides to employ me.  I also understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with the Township of Sparta is of an "at will" nature, which means that the employee may resign at any time and the Township of Sparta 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 the Township of Sparta Appointing Authority.  

     I understand that some positions may require post offer, pre-employment, physical, Drug/Alcohol testing and/or psychological examinations.  I understand, if employed, I will be required to contribute to a State-administered pension system.  I understand most employees and applicants are required to pass a Civil Service exam to obtain permanent appointment. 

     I authorize the Township of Sparta to conduct a background investigation pertaining to my qualifications and the statements contained in this application.  I further authorize the Township to contact the references I have listed on my application.  I understand that this background investigation may include the following and I hereby give my consent.

     A. Credit Check

     B. Reference Check

     C. Review of Driving Record

     D. Physical Examination, including illegal drug and/or alcohol screening (MAY BE CONDUCTED AFTER EMPLOYMENT IS OFFERED BY THE TOWNSHIP.)

     E. Employment History Check

201. If there is a particular employer(s) you do not wish us to contact, please indicate which one(s).

203. I understand any misstatement or omission on this form or during my interview may result in my disqualification for employment or termination of my employment if I have already been appointed.  

     
     

207. First & Last Name*
208. Date*

210. This application for employment shall be considered active for a period of time not to exceed 45 days.  Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.  

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

     This field is not part of the form submission.

214. Submit Submit and Print

* indicates a required field