Application (Roads – Cemetery) – Harris Township Ohio

Personal Information

First Name*

Middle Name

Last Name

Address

Email*

Phone*

Position applied for*

Full/Part Time*

Do you have a valid State of Ohio Driver License?*

YesNo

Do you hold a Driver License in any other State.*

YesNo

Has your Driver License ever been suspended or revoked?*

YesNo

Have you been involved in any traffic accidents where you were cited?*

YesNo

EMPLOYMENT ELIGIBILITY

Are you legally eligible to work in USA?

YesNo

Do you have any physical limitations that prevent you from performing your duties if hired? Please answer yes or no to the following.

Are you willing to submit/pass a controlled substance test?*

Specialized Education

Specialized education or training that would be an asset for the job or any other information that you feel is pertinent to your application. (Attach additional sheet for details if necessary.)

Specialized Education

Education

High School

State, City

College/University

State, City

Other

State, City

PREVIOUS EMPLOYMENT

Current employer (company/Individual)

Address

Job title

Job responsibilities

Any previous employment record - please provide company name and contact info.

REFRENCES

Your reference within this company

Employee ID

Cover Letter, Resume, & References

Disclaimer *

I certify the information above is true to the best of my knowledge and any misleading/ false information in this form may result in job being terminated or not subject for hire. I certify that all information provided herein is true and complete to the best of my knowledge. I hereby authorize the Harris Township Trustees to make any investigations of my criminal, motor vehicle, educational, and employment histories or any other related affairs as maybe necessary in arriving at an employment decision. I also release all persons from liabilities in responding to inquiries regarding my application. In the event of employment, I understand that discovery of false or misleading information in my application or during my employment interview, may result in my discharge. I understand that I am required to follow all rules, regulations, policies, procedures, and job requirements of Harris Township Ohio and that failure to do so may result in discharge.

I accept

Application (Roads – Cemetery)

Harris Township Ohio

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