Town of Kitty Hawk
Application for Employment
We consider applicants for all positions without regard to race, color, creed, gender, national origin, age
disability, marital or veteran status or any other legally protected status
Position(s) Applied
For:
Date of Application:
Applicant Information
Full Name:
Last
First
Middle
Address:
Street Address
Apartment/Unit #
State
ZIP Code
Phone:
Email
Date Available:
Desired Salary:
$
Are you a citizen of the United States?
YES
NO
If no, are you authorized to work in the U.S.?
YES
NO
Have you ever worked for this company?
YES
NO
If yes, when?
Have you ever been convicted of a felony?
YES
NO
If yes, explain:
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:
Town of Kitty Hawk Application
Page 2
References
Please list three professional references.
Full Name:
Relationship:
Company:
Phone:
Address:
Full Name:
Relationship:
Company:
Phone:
Address:
Full Name:
Relationship:
Company:
Phone:
Address:
Previous Employment - Complete additional page if
you have had more jobs in the last seven years
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Pay:
$
Ending Pay:
$
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Pay:
$
Ending Pay:
$
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO
Town of Kitty Hawk Application
Page 3
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Pay:
$
Ending Pay:
$
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO
Other Skills, Certification and Qualifications
Please provide a summary of other job-related skills, qualifications, and certifications:
Military Service
Branch:
From:
To:
Rank at Discharge:
Type of Discharge:
If other than honorable, explain:
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:
click to sign
signature
click to edit
Previous Employment (Complete if Necessary)
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Pay:
$
Ending Pay:
$
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Pay:
$
Ending Pay:
$
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO
Company:
Phone:
Address:
Supervisor:
Job Title:
Starting Pay:
$
Ending Pay:
$
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
YES
NO