Employment History - Please provide information including Name of Firm, Supervisor contact information,
dates of employment, Position and duties, and reason for leaving for each employment instance. Please
indicate if it is permissible to contact the employer: _____ Yes _____ No.
PLEASE NOTE- References should not be included with this application. References will be requested at a later date.
Education History - Please list all schools attended and degrees obtained. Also include any additional skills
and certifications, licenses or other additional training, including languages. This information should be
included in a resume. This space can be used for additional comments.
I understand that any misrepresentation on this application may be reason for immediate dismissal, and that permanent employment
depends on satisfactory replies from references, a favorable report on my medical examination where required, a criminal record
check and successful completion of a probationary period of employment. I also understand that any offer of employment or
appointment and any conditions thereto are contingent and become final only upon written approval of the Chief Justice of the
Supreme Judicial Court. I also understand that I may be subject to transfer in accordance with the provisions of the General Laws. I
further understand that pursuant to the provisions of the Immigration Reform and Control Act of 1986 I will be required to complete
an Employment Eligibility Verification form (I-9) and submit specific document(s) that establish my identity and employment
eligibility after an offer of employment is made.
Date______________________ Signature _____________________________________________________
Pursuant to St. 1978, c. 478, sec. 328, no person who is not a resident of the Commonwealth shall serve as a officer in or an
employee of the Judicial Branch; provided, however, that this provision shall not apply to those persons serving as officers in or
employees of the Judicial Branch prior to the effective date of this section.
The policy of the Judiciary prohibits discrimination on the basis of age, race, religion, color, national origin, sex, sexual orientation,
marital status, Vietnam Era veteran status, or disability. The Judiciary is also committed to employment practices which comply with
the Americans with Disabilities Act.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An
employer who violates this law shall be subject to criminal penalties and civil liability.
