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Town of Remsen Application for Employment

The following form takes about 20 minutes to complete.

Application for Employment

PERSONAL INFORMATION



Referring to your PERMANENT LEGAL ADDRESS, complete all items which apply to where you live.



If you answered “YES” to any of the questions above, you may give specifics under “Remarks” in the last section of this application. If you elect not to provide specifics, or if such explanation is insufficient, you may be required to submit further information. None of the above circumstances represents an automatic bar to employment.

Each case is considered and evaluated on individual merits in relation to the duties and responsibilities of the position (s) for which you are applying.


VETERANS’ CREDITS


If you wish to claim additional credits complete questions 1-4 and submit the member 4 of your DD-214. If you are a Disabled War Veteran, also submit a copy of your benefits letter. 


EDUCATION

Read examination announcement for educational requirements. If required, attach transcripts showing the date degree received, major subject, and/or required credit hours.


College University, Professional or Technical School


1.


2.


3.


Other Classes Or Special Courses


1.


2.


PROFESSIONAL LICENSES

If a license, or other authorization to practice trade or profession is listed as a requirement on the Job Posting or Examination Announcement for which you are applying, complete the following and submit a copy of the license with this application:


DRIVER'S LICENSE


WORK EXPERIENCE

Beginning with your most recent employer, list all employment, military service, or volunteer experience that shows you meet the minimum qualifications for the examination. We cannot interpret omissions or vagueness in your favor. You are responsible for an accurate and clear description of your experience. (Do not send your resume). Describe the work which you personally performed. If you supervised, state how many people and the nature of such supervision.


Employment 1


Employment 2


Employment 3


Employment 4


REMARKS

Use this space to provide any additional information, as necessary.


THIS AFFIRMATION MUST BE COMPLETED

I affirm that the statements made on this application (including any attached documents) are true under the penalties of perjury.


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