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Employment Application

  1. Employment Desired
  2. (per week)
  3. Are you eligible to work in the United States?
  4. Have you ever worked for this organization?
  6. Did you graduate?
  7. Did you graduate?
  10. May we contact your previous supervisor for a reference?
  11. May we contact your previous supervisor for a reference?
  12. May we contact your previous supervisor for a reference?
  14. Are you currently in the Armed Forces?
    Please list three professional references.
  16. Disclaimer and Signature

    I certify that my answers are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that, if hired, I may be released from employment.

    I understand that the Town of Madison may require me to successfully complete a pre-employment drug and alcohol test as a condition of employment and that continued employment may be based on the successful completion of similar tests.

    I understand that the company may as part of the hiring process request an investigative consumer report from a third party entity or agency including information concerning my character, general reputation, personal characteristics, credit records, and mode of living. I may make a written request to the Town of Madison to provide me with additional information regarding the nature and scope of any such report.

    I understand that employment with your company is "at will" and nothing in the interview or hiring process, this application, or the Town of Madison's policies are intended to create an employment contract between myself and the company. Employment may be terminated by either party for any reason with or without notice.

  17. Leave This Blank:

  18. This field is not part of the form submission.