Application For Employment Page 4
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4REFERENCES
Please list professional references. Two (2) must be designated as pervious supervisors.
1.
(
)
-
Name
Title/Relationship
Telephone Number
Company
Address
2.
(
)
-
Name
Title/Relationship
Telephone Number
Company
Address
3.
(
)
-
Name
Title/Relationship
Telephone Number
Company
Address
4.
(
)
-
Name
Title/Relationship
Telephone Number
Company
Address
CONSENT
With the submission of this application I certify that all statements are true and correct to the best of my
knowledge and belief. Any misrepresentations or omissions on this application may be cause for rejection of the
application or dismissal after employment.
I authorize investigation of all statements contained in this application and authorize the Township to perform a
background check as may be necessary in arriving at an employment decision.
I understand that all employees of the Township are employed at-will, which means that either the Township or
the employee may terminate the employment relationship at any time, with or without notice and for any and no
reason. Employees covered by a collective bargaining agreement will be governed by the terms and conditions of
the contract. No employee or representative of the Township has authority to enter into any agreement specifying
duration of employment or abrogating an employee’s at-will employment status. I understand that this application
is not intended to confer any contractual right or obligation to any party and that the Township reserves the right
to change any practice, policy or procedure with or without notice, at its sole discretion.
I understand that the offer of employment is contingent on the results of a pre-employment drug test. Applicants
under 18 years of age must have parental consent. Confirmed positive test results will automatically disqualify an
applicant from employment.
___________________________________________ ________________________
Applicant’s Signature
Date
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