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Town Public Works Employment Application


  1. 1. Personal Information
  2. 2. Education
  3. 3. References
  4. 4. Employment History
  5. 5. Additional Comments & Signature
  • Personal Information

    1. Notice
      By filling out this application, you are authorizing the Town to contact your former or current employers (unless you specifically indicate they can’t be contacted) or other references, as well as any educational institutions listed. All of them are authorized to release any information they may have about you; you agree to release the Town and its employees, as well as all references, from any liability which may result or be claimed because of the information provided (or because of the fact that any information was provided). You further agree to defend and hold harmless the Town of Pinetop-Lakeside and any references or educational institutions from any claims, demands, lawsuits, judgments, or other liability relating to the information provided.
    2. Are you over 18 years of age?*
    3. Are you legally eligible to work in the United States?*
    4. Types of employment you will accept:*
      Check all that apply.
    5. Which shifts can you work?*
      Check all that apply.
    6. Are you able to work weekends?*
      Check all that apply.
    7. Are you a U.S. Citizen, or do you have the legal right to remain permanently in the U.S.?*
    8. If you are required to drive a Town vehicle, do you possess a current valid driver's license?*
      All applicants are required to posses a current Class B Commercial Driver's License at time of employment or with-in 6 months of date of hire.
    9. Have you ever worked for the Town of Pinetop-Lakeside before?*
    10. Are any of your relatives currently employed by the Town of Pinetop-Lakeside?*
    11. Have you ever been discharged, or requested or forced to resign from any position?*
    12. Do you have any reason to believe you will be discharged or requested to resign from your current position within the next thirty days?*
    13. Have you ever served in the Armed Forces?*
    14. Are you eligible to be registered for the Selective Service?*
    15. Have you registered for the Selective Service?