Fillable Employment Application Applicant Information

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Employment Application Applicant Information

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1
Camden County
Employment Application
Applicant Information
Full Name:
Date:
Last
First
M.I.
Address:
Street Address
City
State
Phone:
Email
Social Security No.:
Desired Salary:
$
Position Applied for: _____________________________________
Have you ever worked or been educated under a different name?
YES
NO
Are you 18 years old or older?
YES
NO
Are you eligible for employment in the U.S.?
YES
NO
Have you ever worked for this Camden
County?
YES
NO
If yes, when?
Do you possess a valid New Jersey driver’s
license?
YES
NO
Education
High School:
Address:
From:
To:
Did you graduate?
YES
NO
Diploma:
College:
Address:
From:
To:
Did you graduate?
YES
NO
Degree:
Other:
Address:
From:
To:
Did you graduate?
YES
NO
Degree:
Other:
Address:
From:
To:
Did
Did you graduate?
YES
NO
Degree:
NJ
2
Other Skills
Use this space to describe any licenses, certificates, registration, skills, crafts, including machines or equipment
operated which related to the position for which you are applying.
Previous Employment
Company:
Phone:
Address:
Supervisor:
Job Title:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO
Company:
Phone:
Address:
Supervisor:
Job Title:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO
Company:
Phone:
Address:
Supervisor:
Job Title:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO
3
Are you engaged in other business activity or employment in which you desire to continue if employed by the County of
Camden?
YES
NO
If yes, explain
Do you or does a member of your immediate family own or have an interest in any organization that deals with, is
regulated by or is otherwise affected by the operation of any department of the County of Camden?
YES
NO
If yes, explain
Do you have any relatives who work for
the County?
YES
NO
If yes, name of relative __________________________________________
Relative’s position _____________________________________________
References
List three persons unrelated to you whom we may contact for information concerning your qualifications.
NAME
ADDRESS
PHONE NO.
OCCUPATION
In case of emergency notify: Name___________________________________________
Phone: day______________________ evening _________________________
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or
interview may result in my release.
Signature:
Date:
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Employment Application Applicant Information

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Completed 20 August 2021

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