Fillable Job Application (City of Peabody)

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Job Application (City of Peabody)

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The Job Application (City of Peabody) form is 2 pages long and contains:

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  • 6 check-boxes
  • 76 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Peabody

BROWSE CITY OF PEABODY (MA) FORMS

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City of Peabody
HUMAN RESOURCES DEPARTMENT
24 LOWELL STREET ▪ PEABODY ▪ MA ▪ 01960 PHONES: (978) 538-5721 / (978) 538-5722 FAX: (978) 278-1544
APPLICATION FOR EMPLOYMENT
Date of Application ________________
Name ________________________________________________________________________________________________
Last First Middle
Address ________________________________________________________________________________________________
Number Street Name City/Town State Zip Code
Telephone ________________________________________________________________________________________________
Home # Work # Mobile #
Email _______________________________________________ US Citizen ____ Yes ____ No
Have you ever worked for the City? (If Yes, when and where) ________________________________________________________
When available to work? _____________________________________ Full Time ____ Part Time ____
Position(s) applied for _____________________________________ By whom were you referred? ______________________
If related to anyone employed by the City, list names and department _________________________________________________
Salary requirements _____________________________ Are you at least 18 years of age? ____ Yes ____ No
EDUCATION
SCHOOL
NAME & LOCATION
YEARS COMPLETED
LAST YEAR ATTENDED
DIPLOMA OR DEGREE
MAJOR COURSES
Elementary
High School
College
Special Training or Skills/Graduate School _______________________________________________________________________
EMPLOYMENT EXPERIENCE (Start with your present or last job)
Company ________________________________________ Address __________________________________________
City ____________________________ State _____ Zip Code __________ Telephone ___________________
Supervisor _____________________________________ Reason for Leaving ________________________________
Position Starting _________________________________ Position at Termination ____________________________
Dates Employed From ______________ To _______________
Company ________________________________________ Address __________________________________________
City ____________________________ State _____ Zip Code __________ Telephone ___________________
Supervisor _____________________________________ Reason for Leaving ________________________________
Position Starting _________________________________ Position at Termination ____________________________
Dates Employed From ______________ To _______________
Company ________________________________________ Address __________________________________________
City ____________________________ State _____ Zip Code __________ Telephone ___________________
Supervisor _____________________________________ Reason for Leaving ________________________________
Position Starting _________________________________ Position at Termination ____________________________
Dates Employed From ______________ To _______________
US MILITARY
In the event of an emergency, who would you wish to be notified? (Name, Address and Phone Number)
___________________________________________________________________________________________________________
BUSINESS AND PERSONAL REFERENCES
(Give name, address, and telephone number of three (3) references (who are not related to you)
1
2
3
READ CAREFULLY BEFORE SIGNING
I authorize investigation by the City of all statements contained in this application and hereby release those individuals and
corporations who are parties thereto from any and all liability and damage resulting from or arising out of such investigation.
I consent to taking a pre-employment physical examination, including a drug screen and such future physical examinations as may
be required by the City.
I understand that any misrepresentation or omission of essential facts in this application is cause for cancellation of the application
or if employed, for immediate separation from City’s service.
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Job Application (City of Peabody)

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Completed 27 July 2020

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