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Seasonal/Temporary Application - DPW

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1. Seasonal and Temporary Employment Application(current) This section is complete This section is incomplete
2. Submit This section is complete This section is incomplete

Full Name*
Address*
City*
State*
Zip Code*
Phone Number*
Email Address*
Are you currently, or have you ever worked for the Town? (including schools)*
1. Yes
2. No
If yes, when?
In which department?
Do you have an immediate family member (i.e. spouse, mother, father, sibling or child) working for the Town of South Hadley?*
1. Yes
2. No
If yes, what's the employee's name?
In which department?
Will you be 17 years of age or older by June 1 of the current year?*
(Due to the equipment used in this position, we can only consider candidates that are 17 years of age or older)
1. Yes
2. No
List previous employers and include job duties/responsibilities.*
List four references, three personal and one employment.
Name*
Occupation*
Phone Number*
Email Address
Street Address
City
State
Zip Code
Name*
Occupation*
Phone Number*
Email Address
Street Address
City
State
Zip Code
Name*
Occupation*
Phone Number*
Email Address
Street Address
City
State
Zip Code
Name*
Occupation*
Phone Number*
Email Address
Street Address
City
State
Zip Code
Continue

Qualified applicants will be considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or handicap which does not preclude the applicant from performing the essential functions of the job with or without reasonable accommodation.
Applicant's Signature*
Date*
Date

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