AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY - Territories - AS GU MP PR UM VI - Armed Forces - AA AP AE

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AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY - Territories - AS GU MP PR UM VI - Armed Forces - AA AP AE

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A B C

Yes No

Last Name *

Phone # *

Do you have a valid Driver's License?

Social Security #

Applicant Details

How did you learn about this position?

Are you currently employed?

Do you have a valid CDL License?

Work #

Pursuant to Federal Law, Proof of U.S. Citizenship, or Immigration Status will be required if you are hired.

May we contact you at work?

ZIP *

City *

Employment is conditional upon the results of a criminal background check. An answer of "Yes" may disqualify you from employment depending upon the circumstances involved. If 'Yes", please explain below:

State *

Cell Phone #

Phone Number

Previous/Alternate Names

Full Name

Are you currently on layoff status with subject to recall?

Are you legally eligible to work in the United States of America? *

If yes, list hours and/or days:

Availability

May we contact your current employer?

If yes, please provide the date:

For positions requiring a Driver's License and/or CDL License

Have you previously applied here? *

Learn About Position Other

Have you ever pleaded guilty or been found guilty of a crime or disorderly persons offense? *

Date of Birth *

Current Employer Details

Email *

Driver's License State

Other Details

List any equipment operated or other qualifications:

What day can you start?

Address *

Relationship

Employment Eligibility

First Name *

CDL Class

Any offer of employment by the Borough of Deal will be conditional upon your providing documentation required by law as evidence of personal identity and your authorization to work in the United States.

License Details

Application Details

Driver License #

Are there any hours and/or days you cannot or will not work? *

Middle Name

Emergency Contact Details

CDL License #

If you are under eighteen years of age, can you provide proof of eligibility to work? *

Desired Salary

EDUCATION: Provide information on your formal schooling and education below. Include elementary, secondary, and post-secondary education, if any. Include any formal vocation or professional education. For high school and post-secondary education, indicate any major specialty, such as academic, business, or trade. *

Education/Training Details

COMMENTS & ADDITIONAL INFORMATION: Is there any additional information about you we should consider?

SPECIAL SKILLS & EXPERIENCE: List any special skills, experience, training, licenses, certifications you have that are relevant to the position for which you are applying, or any additional information that we should consider.

LANGUAGES: Please enter all known languages below.

You MUST add atleast one new record to submit your application.

Yes No

Will Will not

Yes No

Based on the job description of the position for which you are applying you: *

need reasonable accommodations in order to perform the essential functions of this job.

Describe any accommodations you will need to adequately perform the essential functions of the position.

Employment History

If yes, are there any you wish to exclude?

Active Duty Start Date:

If yes, list Branch of Service:

Active Duty End Date:

This section must be completed even if you attach a resume. List your last four employers and major assignments within the same employer. Begin with the most recent. Include any military service. Explain any gaps in employment in the space on this form marked "Comments" located on the bottom of this page. *

Have you served in the US Armed Forces? *

Comments

May we contact these companies/institutions for references? *

Date of Final Discharge:

You MUST add atleast one new record to submit your application.

Provide the names, addresses, and phone numbers of three people whom we may contact as a reference. They should not be relatives or former supervisors. *

You MUST add atleast one new record to submit your application.

References

Resume

Submit your resume by attaching it below. Attach resume in Word or PDF file format.

Male Female

Hispanic White (Non Hispanic) Black or African American Asian Native Hawaiian or Other Pacific Islander American Indian or Alaska Native Other I choose not to self-identify

Yes No

Yes No

Yes No

Yes No

Yes No

I AM A VETERAN WHO SERVED ON ACTIVE DUTY DURING THE WAR OR IN A CAMPAIGN OR EXPEDITION FOR WHICH A CAMPAIGN BADGE HAS BEEN AUTHORIZED.

IMPORTANT—To ALL Applicants: To enable us to meet government reporting regulations, the Borough of Deal requests you complete this personal data form. Information will be used solely for government reporting purposes and will be detached and kept separate from your application. Any information you choose to provide will not be considered by the Borough of Deal for employment purposes and will be treated as confidential. Your voluntary cooperation is appreciated.

If any of these definitions apply to you, please choose the appropriate choice. If you identify as more than one please choose "Other".

(A) was discharged or released with other than a dishonorable discharge;

Equal Employment Opportunity

The Borough of Deal is asking you to provide this information, because we must submit a statistical report in accordance with the regulations promulgated under 38 U.S.C. Section 2012 and must monitor statistics for the U.S. Government.

(1) A person who served more than 180 days of active military, naval or air service, any part of which was during the period August 5, 1964 through May 7, 1975 and who:

Veteran Status

Voluntary Information Only

Gender

Race/Ethnic Category

I AM A VETERAN OF THE VIETNAM ERA

I qualify as a veteran of the Vietnam Era because I am:

I AM A SPECIAL DISABLED VETERAN

(B) was discharged or released from active duty because of a service connected disability.

Signature *

As an applicant for a position with the Borough of Deal, I understand and agree that I must provide truthful and accurate information is not complete, true and accurate. If hired, I understand that I may be separated from employment if the Borough later discovers that the information on this form was incomplete, untrue, or inaccurate. I give the Borough the right to investigate the information I have provided, talk with former employers (except where I have indicated they may not be contacted). I give the Borough the right to secure additional job-related information about me. I release the Borough and its representatives from all liability for seeking such information. I understand that the Borough is an equal-opportunity employer and does not discriminate in its hiring practices. I understand that the Borough will make reasonable accommodations as required by the Americans with Disabilities Act. I understand that, if employed, I may resign at any time and that the Borough may terminate me at any time in accordance with its established policies and procedures. No representatives of the Borough may make any assurances to the contrary. I understand that any officer of employment may be subject to job-related medical, physical, drug, or psychological tests. I also understand that some positions may involve complete background and criminal checks.

The Borough of Deal is an AT-WILL, EQUAL OPPORTUNITY EMPLOYER and does not discriminate on the basis of race, sex, color, religion, national origin, age, disability or veteran status in employment opportunities and benefits.

Acknowledgement