Employment Application
{[CITY]}, {[STATE]} {[ZIP]}
  • Applicant
  • Education/Training
  • Employment History
  • Driver's/CDL License
  • EEO
  • Certification
Overtime *
Last Name *
Position Applying For *
Phone Number *
Part Time *
Shift Work *
Have you ever plead guilty or been found guilty of a crime; disorderly persons offense; or a municipal ordinance involving moral turpitude? *
Employment is conditional upon the results of the criminal background check. An answer of “Yes” may disqualify you from employment depending upon the circumstances involved. If “Yes”, please explain below.
Alternate Phone Number
City *
Temporary *
State *
Preferred Name
Are you legally eligible for employment in the U.S.? *
Date you can start
Full Time *
Social Security Number *
Employment Eligibility
Email *
Belmar only accepts online applications. It is important that your application be complete and thorough. Please include all requested education, experience, attachments, and other information. Resumes and other supporting documents can be provided at the time of application; however, resumes will not be accepted in lieu of an application. Incomplete applications are subject to rejection. Notifications to applicants are sent electronically to the email address you provide.
Salary desired
Applicant Details
Address *
First Name *
Any offer of employment by Belmar will be conditional upon your providing documentation required by law as evidence of personal identity and your authorization to work in the United States.
Job Interest
Are you over 18 years of age? *
Education and Training Experience
Comments & Additional Information: Is there any additional information about you we should consider?
Attach resume below in Word or PDF file format.
State any special skills, experience, training, licenses, certifications or other factors that make you especially qualified for the position for which you are applying.
Enter previous education and training experience below.
List at least three people we may contact in reference to your application.
Are any of your relatives employed by Belmar? *
Are you currently employed?
Click "Add New Record" for each employment in descending order from Current (Last) Employer *
Employment History
If Yes, enter position(s)
Have you previously been employed by Belmar? *
May we contact you at work?
If Yes, list name, department and relationship
Have you ever applied to Belmar? *
May we contact your current employer?
If Yes, give date
Are you currently on layoff status and subject to recall?
Do you have a valid Driver's License?
Do you have a valid CDL License?
Driver's/CDL License
For positions requiring a Driver's License and/or CDL License
Driver's License State
List any equipment operated or other qualifications
CDL Class
Driver License Number
CDL License Number
IMPORTANT—To ALL Applicants: To enable us to meet government reporting regulations, Belmar requests you to 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 Belmar for employment purposes and will be treated as confidential. Your voluntary cooperation is appreciated.
Veteran Status
Voluntary Information Only
  • Hispanic or Latino – a person of Cuban, Mexican, Puerto Rican, South or Central America, or other Spanish culture, regardless of race.
  • White – a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
  • Black or African American – a person having origins in any of the black racial groups of Africa.
  • Native Hawaiian or Other Pacific Islander – a person having origins in any of the peoples of Hawaii, Guam, or the Pacific Islands.
  • Asian – a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
  • American Indian or Alaska Native – a person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community recognition.
  • Two or More Races – all persons who identify with more than one of the above five races.
Equal Employment Opportunity
Type Full Name :
Sign With Hand
Conditions of Employment
Understandings and Agreements
Signature *

As an applicant for a position with the Borough of Belmar, I understand and agree that I must provide truthful and accurate information in this application. I understand that my application may be rejected if any information is not complete, true and accurate. If hired, I understand that I may be separated from employment if the Borough of Belmar later discovers that information on this form was incomplete, untrue, or inaccurate. I give the Borough of Belmar 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 of Belmar the right to secure additional job-related information about me. I release the Borough of Belmar and its representatives from all liability for seeking such information. I understand that the Borough of Belmar is an equal-opportunity employer and does not discriminate in its hiring practices. I understand that the Borough of Belmar 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 of Belmar may terminate me at any time in accordance with its established policies and procedures. No representatives of the Borough of Belmar may make any assurances to the contrary. I understand that any offer 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.

Please be advised that all offers of employment are conditional on the applicant passing a mandatory criminal background check and drug test. A pre-employment physical may also be required. Pursuant to our personnel policy, all job applicants are required to sign a consent form for drug testing and if the test results are positive and are not accounted for by the legal use of prescription or non-prescription drugs the applicant shall be ineligible for hire unless they can establish a legal basis for the use of the drug or controlled substance for which they test positive. For your application to be considered, you must sign below.

Belmar 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.