Application for Temporary/Seasonal/Summer Employment

Dept Name

Applicant Information

To complete the paper form, click here

Applicant Name *

Applicant Phone Number *

Applicant Cell Phone *

Applicant Address *

City *

State *

Zip Code *

Applicant Email *

Position Desired *

Are you 18 Years Old or Older? *

Yes No

Education

High School

Diploma Type

College/Trade School

Skills or Trade

Emergency Contacts

Please provide the name and telephone numbers (home, work, and cell) for two people who should be contacted in the event of an emergency

Contact Name *

Home Phone *

Work Phone *

Cell Phone *

Contact Name *

Home Phone *

Work Phone *

Cell Phone *

Employment Information

Employer *

Supervisor Name *

Phone Number *

Employer Address *

City *

State *

Zip Code *

Date Started *

Date Ended

Have you ever worked for the Township of Springfield Before? *

Yes No

Are you applying for a Public Works Department Position? *

Yes No

Driver's License Number *

State *

Class *

Expiration Date *

CDL *

Yes No

References

Reference Name *

Reference Phone Number *

Reference Address *

City *

State *

Zip Code *

Applicant's Statement

I certify that the answers given herein are true and complete.

This application for employment shall be considered on a temporary/seasonal/summer basis.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with the Township 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.

In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. Understand, also, that I am required to abide by all rules and regulations of the employer.

Use the Drawing Tool to Sign in the Appropriate Box Below

Applicant Signature

Date Signed *

Signature of Supervisor

Date Signed

Signature of Witness

Date Signed

Application for Temporary/Seasonal/Summer Employment

Dept Name

Applicant Information

Education

Emergency Contacts

Employment Information

References

Applicant's Statement

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