Application For Employment - Human Resources Department - City Of Claremont Page 3
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4Human Resources Department
58 Opera House Square
Claremont, NH 03743
EMPLOYMENT HISTORY
(List most recent employer first, please account for any gaps in employment record)
Company:____________________________________________________ Your Title:___________________________
Street Address:___________________________________________ Employed From:____________________________
City, State, Zip:_____________________________________________ Employed To:____________________________
May we contact your present employer?
Yes_____
Salary or Rate of Pay: Starting_____ Per_____
No_____
Ending_____ Per_____
Responsibilities:____________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Supervisor’s Name:_________________________________________________ Phone __________________________
Reason for leaving:_________________________________________________________________________________
_________________________________________________________________________________________________
Company:____________________________________________________ Your Title:___________________________
Street Address:___________________________________________ Employed From:____________________________
City, State, Zip:_____________________________________________ Employed To:____________________________
May we contact your present employer?
Yes_____
Salary or Rate of Pay: Starting_____ Per_____
No_____
Ending_____ Per_____
Responsibilities:____________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Supervisor’s Name:_________________________________________________ Phone __________________________
Reason for leaving:_________________________________________________________________________________
_________________________________________________________________________________________________
Company:____________________________________________________ Your Title:___________________________
Street Address:___________________________________________ Employed From:____________________________
City, State, Zip:_____________________________________________ Employed To:____________________________
May we contact your present employer?
Yes_____
Salary or Rate of Pay: Starting_____ Per_____
No_____
Ending_____ Per_____
Responsibilities:____________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Supervisor’s Name:_________________________________________________ Phone __________________________
Reason for leaving:_________________________________________________________________________________
_________________________________________________________________________________________________
Company:____________________________________________________ Your Title:___________________________
Street Address:___________________________________________ Employed From:____________________________
City, State, Zip:_____________________________________________ Employed To:____________________________
May we contact your present employer?
Yes_____
Salary or Rate of Pay: Starting_____ Per_____
No_____
Ending_____ Per_____
Responsibilities:____________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Supervisor’s Name:_________________________________________________ Phone __________________________
Reason for leaving:_________________________________________________________________________________
_________________________________________________________________________________________________
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