Job Application

To apply for an open position with the Town of Whitestown, complete the application form. Please indicate the position desired and don’t leave it blank.

Personal Information

First Name(Required)

Middle(Required)

Last Name(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Are you 18 years of age or older?(Required)

Yes

Are you legally eligible to work in the United States?(Required)

Yes

Have you ever previously been employed by this Town?(Required)

Yes

If Yes, when?(Required)

Do you now or have you ever had a relative employed by this Town?(Required)

Yes

If yes, who?(Required)

Can you perform the essential functions of the job with or without reasonable accommodation?(Required)

Yes

Have you ever been arrested or convicted of a crime that has not been expunged by a court?(Required)

Yes

If Yes, please explain.(Required)

*Candidates selected for probable employment who are age 18 or older may be required to consent to a background check as a condition of employment.

Employment Desired

Positioned Desired(Required)

(Please list the title of the position as posted and do not leave blank or list “any.”)

Date Available to Start?(Required)

Status Desired(Required)

Full-time

Part-time

Desired Hourly Rate / Base Salary?(Required)

Work Hours

Weekday- Daytime Hours(Required)

Yes

Weekday - Evening Hours(Required)

Yes

Saturday(Required)

Yes

Sunday(Required)

Yes

Education Information

High School

Name and Location of School

Number of Years Attended

Degree Received

Subjects Studied / Major

College or University

Name and Location of School

Number of Years Attended

Degree Received

Subjects Studied / Major

Other (Technical / Trade School / Business School / Other

Name and Location of School

Number of Years Attended

Untitled

Degree Received

Subject Studied / Major

Resume / Cover Letter / Additional Information(Required)

Drop files here or

Accepted file types: pdf, Max. file size: 50 MB, Max. files: 4.

Please attached an additional information necessary (PDF format only).

Employment History

Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

Please attach your Resume with any additional jobs.

Are currently employed?(Required)

Yes

If Yes, may we contact your present employer?(Required)

Yes

Current or Most Recent Job

Start and End Date of Employment

Name of Employer

Employer's Address

Please enter full address (street, city, state and zip code).

Position / Title

Supervisor's Name / Title

Job Status

Full-time

Part-time

Rate of Pay

Hourly rate of yearly salary

Reason for Leaving

Enter N/A if not applicable

Job Duties / Responsibilities

Other Jobs

Start and End Date of Employment

Name of Employer

Employer's Address

Please enter full address (street, city, state and zip code).

Position / Title

Supervisor's Name / Title

Job Status

Full-time

Part-time

Rate of Pay

Hourly rate of yearly salary

Reason for Leaving

Enter N/A if not applicable

Job Duties / Responsibilities

Start and End Date of Employment

Name of Employer

Employer's Address

Please enter full address (street, city, state and zip code).

Position / Title

Supervisor's Name / Title

Job Status

Full-time

Part-time

Rate of Pay

Hourly rate of yearly salary

Reason for Leaving

Enter N/A if not applicable

Job Duties / Responsibilities

Other Skills, Memberships and Affiliations

Do you have any special skills, volunteer experience and/or training that would enhance your ability to perform the position applied for?(Required)

Yes

If Yes, please explain.(Required)

Do you hold a license or professional certification?(Required)

Yes

If Yes, please explain.(Required)

Do you participate in any professional associations that would enhance your ability to perform the position applied for?(Required)

Yes

If Yes, please explain(Required)

References

Please give the names of three persons not related to you, and preferably who you have worked with/for and whom you have known at least 3 years.

Contact Information(Required)

Name

Phone

Company

Years Known

Consent

The Town of Whitestown is an equal opportunity employer. The Town of Whitestown does not discriminate in employment on account of race, color, religion, sex (pregnancy, gender identity, and sexual orientation), national origin, age (40 and over), disability, genetic information as referenced in the Genetic Information Nondiscrimination Act (GINA), military service veteran status or any other protected class as defined by federal, state, and local laws. The Town of Whitestown will comply with its obligation to provide reasonable accommodation to qualified individuals with disabilities.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes an obligation for the Town of Whitestown to hire me. If I am hired, I understand that either the Town of Whitestown or I may terminate employment at any time for any reason, with or without cause and without prior notice. I understand that no representative of the Town of Whitestown has the authority to make any assurance to the contrary. In addition, I understand that the Town of Whitestown utilizes the national E-Verify system to confirm my employment eligibility.

I attest with my signature below that I have given to the Town of Whitestown true and complete information on this application. No requested information has been concealed. I authorize the Town of Whitestown to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for denial of employment or immediate dismissal.

Signature

Note: Applications for employment will be kept on file for three-years from the date of completion.

Comments

This field is for validation purposes and should be left unchanged.

How can we help?

Job Application

Personal Information

Employment Desired

Work Hours

Education Information

Employment History

Other Skills, Memberships and Affiliations

References

Consent

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