Employment Application

General Information

Full Name

Phone Number

Email Address

Street Address

City

State

Zip Code

Do you have a valid driver's license?

License Class

License Issuing State

Best Time to Call

Are you 18 years of age or older?

Are you related to any Village employee or elected official?

If related, state name and relationship

Have you been previously employed by the Village?

If previously employed, when and what position?

Are you prevented from lawfully being employed due to Visa or Immigration Status?

Position Information

Position Applying For

Date Available for Work

Resume

Click to upload or drag and drop

Accepted: PDF, DOC, DOCX (Max 10MB)

Cover Letter

Click to upload or drag and drop

Accepted: PDF, DOC, DOCX (Max 10MB)

Will you work overtime if required?

If no overtime, please explain

Have you ever been convicted of a crime (other than minor traffic)?

If convicted, provide dates and details

How did you hear about this position?

If Job Website or Other, please specify

Educational Background

Education 1 - Most Recent

Education 2

Education 3

Skills and Qualifications

Special Training, Skills, Licenses, Certificates

Job-Related Organizations

Special Accomplishments, Publications, Awards

Other Job-Related Information

Employment History - Employer 1 (Most Recent)

Employer 1 - Company Name

Employer 1 - Phone

Employer 1 - Address

Employer 1 - Job Title (Starting/Final)

Employer 1 - Dates Employed

Employer 1 - May we contact?

Employer 1 - Supervisor Name and Title

Employer 1 - Supervisor Email

Employer 1 - Reason for Leaving

Employer 1 - Job Responsibilities

Employer 1 - What did you like most?

Employer 1 - What did you like least?

Employment History - Employer 2

Employer 2 - Company Name

Employer 2 - Phone

Employer 2 - Address

Employer 2 - Job Title (Starting/Final)

Employer 2 - Dates Employed

Employer 2 - May we contact?

Employer 2 - Supervisor Name and Title

Employer 2 - Supervisor Email

Employer 2 - Reason for Leaving

Employer 2 - Job Responsibilities

Employer 2 - What did you like most?

Employer 2 - What did you like least?

Employment History - Employer 3

Employer 3 - Company Name

Employer 3 - Phone

Employer 3 - Address

Employer 3 - Job Title (Starting/Final)

Employer 3 - Dates Employed

Employer 3 - May we contact?

Employer 3 - Supervisor Name and Title

Employer 3 - Supervisor Email

Employer 3 - Reason for Leaving

Employer 3 - Job Responsibilities

Employer 3 - What did you like most?

Employer 3 - What did you like least?

Employment Gaps & Terminations

Explain any gaps in employment

Have you ever been terminated or asked to resign?

If terminated, please explain

References (3-5 business/work references, not relatives or previous supervisors)

Reference 1 - Name

Reference 1 - Title

Reference 1 - Phone

Reference 1 - Email

Reference 1 - Years Known

Reference 2 - Name

Reference 2 - Title

Reference 2 - Phone

Reference 2 - Email

Reference 2 - Years Known

Reference 3 - Name

Reference 3 - Title

Reference 3 - Phone

Reference 3 - Email

Reference 3 - Years Known

Applicant Statement

I certify that all information provided is true, complete, and accurate

I understand this application remains current for only six months

I understand employment is on an AT-WILL basis

I understand a post-offer medical exam and drug screen is required

I understand false information may result in discharge

Applicant Signature

By typing your name above, you are signing this document electronically

Signature Date

Background Check Consent

I authorize release of employment, criminal, credit, and driving records

I understand fingerprints will be taken for background check

Background Check Signature

By typing your name above, you are signing this document electronically

Background Check Signature Date

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