PLEASE COMPLETE THE APPLICATION BELOW AND UPLOAD THE FOLLOWING DOCUMENTS/INFORMATION TO THIS FORM BEFORE SUBMITTING YOUR APPLICATION:
DRIVERS LICENSE AND ALL STATE CERTIFICATIONS (EMT / Fire, Etc.)
* Information is required.
| * Please list the position for which you are applying: |
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| * Have you ever filed an application with us before? |
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| If Yes, give date: |
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| * Have you ever been employed with us before? |
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| If Yes, give date: |
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| * Are you related to any current employee(s)? |
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| If Yes, give name(s): |
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| * Are you currently employed? |
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| * May we contact your present employer? |
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| * On what date would you be available for work? |
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| * Do you have a valid Ohio drivers license? Please note Sycamore Township employees must maintain a driving record insurable through the Township's auto insurance carrier in order to operate any Township-owned vehicle. |
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| * Are you prevented from lawfully becoming employed in this
country because of Visa or Immigration Status? |
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| * Can you provide required proof of your eligibility to work? |
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| * High School Name and Location: |
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| * Years Completed: |
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| * Diploma/Degree: |
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| * Describe Course of Study and Any Honors Received: |
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| College/University Name and Location: |
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| Years Completed: |
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| Diploma/Degree: |
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| Describe Course of Study and Any Honors Received: |
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| Other Education (Please Specify) School Name and Location: |
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| Years Completed: |
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| Diploma/Degree: |
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| Describe Course of Study and Any Honors Received: |
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| Starting with your present or last job, please list your employment experience. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status. Employer #1 Name: |
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| Employer #1 Address and Telephone Number: |
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| Employer #1 Job Title: |
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| Employer #1 Supervisor's Name: |
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| Employer #1 Dates Employed: |
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| Employer #1 Describe Work Performed: |
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| Employer #1 Reason for Leaving: |
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| Employer #1 May We Contact? |
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| Employer #2 Name: |
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| Employer #2 Address and Telephone Number: |
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| Employer #2 Job Title: |
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| Employer #2 Supervisor's Name: |
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| Employer #2 Dates Employed: |
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| Employer #2 Describe Work Performed: |
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| Employer #2 Reason for Leaving: |
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| Employer #2 May We Contact? |
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| Employer #3 Name: |
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| Employer #3 Address and Phone Number: |
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| Employer #3 Job Title: |
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| Employer #3 Supervisor's Name: |
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| Employer #3 Dates Employed: |
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| Employer #3 Describe Work Performed: |
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| Employer #3 Reason for Leaving: |
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| Employer #3 May We Contact? |
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| Please list any computer skills or other special skills you possess: |
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| * References: Please provide the name, address and phone number of three references who are not related to you.
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| Emergency Contact Name, Address, Phone Number and Relationship:
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| * I certify that the facts contained in this application are true and complete to the best of my knowledge. I hereby authorize you to conduct a thorough investigation of all statements, written and oral, made by me during the employment application process. I release all parties from any liability in connection with the provision and use of such information. |
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| * I understand and agree that any falsification, misrepresentation, or omission either on the employment application form or in my responses to questions asked during the interview or examination process may disqualify me from further consideration for employment, or if employed, will subject me to immediate termination whenever the falsification, misrepresentation, or omission is discovered. In this regard, where an item is left blank on the
employment application, it is because there is no information within its scope. |
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| * I understand and agree that, if employed by this organization; I will abide by its rules and regulations which I understand are subject to change. |
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| * I understand that a physical examination and a chemical test for the presence of illegal and controlled substances may be required before the commencement of and/or during my employment. I release Sycamore Township Fire Department, its authorized agents, and its employees, and all other persons, companies, and other entities from any and all liability arising out of any physical examination or chemical testing or for the taking of any action
based on the results of any physical examination or chemical testing. |
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| * I understand that as a condition of my employment I will be required to produce a local criminal background check and a copy of my driving record from my insurance company. I also understand that I will be required to take a drug and alcohol test prior to my employment. |
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| * Do you agree to accept messages from the Sycamore Township Fire Department in regard to this application by text? |
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| If Yes, please provide your cell phone number if it is not already listed above. |
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| * Please enter an electronic signature with date below to signify your acceptance of the above statements and that you agree to submit a background check and drivers license report to Sycamore Township as a condition of employment. |
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* Information is required.
We consider applicants for all positions without regard to race, color, religion, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. We are an Equal Opportunity Employer.
