Type of Work ______________________________ Date Employed From ______________ To _____________
Names and Address of Employer ________________________________________________________________
Type of Work ______________________________ Date Employed From ______________ To _____________
Names and Address of Employer ________________________________________________________________
Type of Work ______________________________ Date Employed From ______________ To _____________
You must file a separate Labor Service application for each City or Town in which you wish to be considered. Application may
be made in person or by mail at the Labor Registration Office in each City or Town listed below:
INFORMATION ABOUT POSITION TITLES FOR WHICH YOU MIGHT REGISTER MAY BE OBTAINED AT THE
LOCAL REGISTRATION OFFICES:
ACUSHNET, AGAWAM, ARLINGTON, ATTLEBORO, BEVERLY, BILLERICA, BROCKTON, BROOKLINE,
BURLINGTON, CAMBRIDGE, CHELSEA, CHICOPPEE, DARTMOUTH, DEDHAM, EAST HAMPTON, EVERETT,
FAIRHAVEN, FALLRIVER, FALMOUTH, FITCHBURG, FRANKLIN, GARDNER, GLOUCESTER, HAVERHILL,
HOLYOKE, HULL, LEOMINSTER, LOWELL, LYNN, MALDEN, MARLBOROUGH, MEDFORD, MELROSE,
METHUEN, MILTON, NEW BEDFORD, NEWTON, NORTH ADAMS, NORTHHAMPTON NORTH ANDOVER, NORTH
READING, NORWOOD, PEABODY, PITTSFIELD, QUINCY, RANDOLPH, REVERE, SALEM, SAUGUS,
SHREWSBURY, SOMERVILLE, SOUTH HADLEY, SPRINGFIELD, STONEHAM, STOUGHTON, SWAMPSCOTT,
TAUNTON, TEWKSBURY, WALTHAM, WATERTOWN, WESTFIELD, WEST SPRINGFIELD, WINTHROP, WOBURN,
WORCESTER.
Note; 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.