Sharpsburg Borough Application for Employment Non-Uniform "*" indicates required fields Part I: Basic InformationName* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Position for which your are applying*How did you learn about this position?*If hired, when could you start?*Part II: Other QuestionsAre your currently employed?* Yes No Have you ever been fired or asked to resign from a job?* Yes No Have you served in the US military?* Yes No Do you have the legal right to work in the US?* Yes No Are you able to work on a regular basis and report to work on time?* Yes No Have you ever been convicted of a crime?* Yes No If yes, please list all convictions with dates in the space below.*Part III: Work HistoryPlease attach a current resume or complete the section below.Upload resume?* Yes, I would like to upload my resume in lieu of completing the work history section below. No, I will complete the work history section below. Resume*Accepted file types: pdf, doc, Max. file size: 20 MB. Current or most recent employerDates EmployedEmployer NameEmployer AddressTitleKey responsibilitiesAdditional Employment history 1Dates EmployedEmployer NameEmployer AddressTitleKey responsibilitiesAdditional Employment history 2Dates EmployedEmployer NameEmployer AddressTitleKey responsibilitiesAdditional Employment history 3Dates EmployedEmployer NameEmployer AddressTitleKey responsibilitiesPart IV: ReferencesPlease list the names and contact information for three people that we may contact.Reference 1Name - Reference 1 First Last Title - Reference 1Relationship - Reference 1Address - Reference 1Phone - Reference 1Email - Reference 1 Reference 2Name - Reference 2 First Last Title - Reference 2Relationship - Reference 2Address - Reference 2Phone - Reference 2Email - Reference 2 Reference 3Name - Reference 3 First Last Title - Reference 3Relationship - Reference 3Address - Reference 3Phone - Reference 3Email - Reference 3
