Application Form For Temporary/seasonal/summer Employment

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TOWNSHIP OF SPRINGFIELD
50 POWELL ROAD
SPRINGFIELD, PA 19064
Office 610-544-1300
Fax 610-544-3012
APPLICATION FOR TEMPORARY/SEASONAL/SUMMER EMPLOYMENT
Date:___________
Name: ___________________________________
Phone # _______________________
Address: ________________________________
Cell #
________________________
_________________________________
E-Mail ________________________
Temporary/Part-Time
Position Desired __________________________
Are you 18 years old or over?
Yes
No
EDUCATION
High School: _____________________________
GED
or Diploma
College/Trade School: _____________________
Skills or Trade ___________________
EMPLOYMENT RECORD
Employer ________________________________
Date Started ____________________
Address _________________________________
Date Finished ___________________
Name of Supervisor _______________________
Phone # ________________________
Employer ________________________________
Date Started ____________________
Address _________________________________
Date Finished ___________________
Name of Supervisor _______________________
Phone # ________________________
PERSONAL
Have you ever worked for the Township of Springfield before?
Yes
No
Complete the following if applying for a Public Works Department Position:
Driver’s License Number___________________State____Class______Expiration Date _________
CDL
Yes
No

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