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Form Section 1

Town of Somers Application for Employment (An Equal Opportunity Employer)

Personal Information

Date Picker
Date Picker
Are you 18 years or older?
Are you legally permitted to work in the United States?

Proof of lawful employment eligibility in the United States will be required upon employment in accordance with the Immigration Reform and Control Act of 1986.

Form Section 2

Employment Desired

Date You Can Start
Date Picker
Are you employed now?
May we contact your current employer?
Have you ever applied to this town before?
Have you ever worked for this town before?
Form Section 3

Education

Did you graduate from high school?

Did you graduate from college/university?

Did you graduate from Graduate school?

Did you graduate from Trade or Business school?
Form Section 4

General

Do you have a professional or trade license?
Do you have a drivers license?
Form Section 5

Former Employers 

List below last three employers, starting with your most recent employer first. 

May we contact supervisor?

May we contact supervisor?

May we contact supervisor?
Form Section 6

References



Form Section 7

Certification and Authorization

"I certify that the facts and responses set forth in this application, or otherwise made by me, are true and complete to the best of my knowledge and belief. I authorize the investigation of all statements contained in this application or otherwise made by me, as may be necessary in arriving at an employment decision. I understand that any false statements made by me in this application, or otherwise, constitute sufficient cause for rejection of this application or, if employed, grounds for dismissal. I also understand that this application for employment is not a contract and is not intended to confer or create contractual rights of any kind or nature. No representations have been made to me by the Employer and I have no relied upon any representations by the Employer."

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