WRIGHTSVILLE BOROUGH EMPLOYMENT APPLICATION THE BOROUGH OF WRIGHTSVILLE York County Pennsylvania  APPLICANT INFORMATION Last! Name Street Address City Phone Date. Available Position Applied for  First  M.I. Date Apartment/Unit # ZIP  State E-mail Address  Social Security No.  Desired Salary  Arey youa a citizen oft the United States? Have you ever worked for this company? Havey youe ever been convicted ofaf felony?  YES D NO D Ifno, are) you: authorized to worki in the YES a NO D  U.S.?  YES D NO D Ifso, when? YES D NO D Ifyes,  explain  EDUCATION High School From College From Other From  Address Address Address  To To To  Degree Degree Degree  REFERENCES  Please list three proesionalreerences  Fulll Name Company Address  Relationship Phone C )  1    WRIGHTSVILLE BOROUGH EMPLOYMENT APPLICATION  Fulll Name Company Address Full Name Company Address SKILLS/ / KNOWLEDGE Swperysoly/Mamagement  Relationship Phone ( )  Relationship Phone ( )  Please circle which: skils/knowledge) youp possess and provide any important information.  CDL: Snow Plowing: Commercial Mower: Landscaping: Municipal Operations: Paving: Mechanical: Heavy Machinery: Power Tools: Administrative: Other:  2    WRIGHTSVILLE BOROUGH EMPLOYMENT APPLICATION  PREVIOUS EMPLOYMENT Company Address Job Title Responsibilities  Phone ( ) Supervisor $  Starting Salary  Ending Salary  $  From  To  Reason for Leaving  May we contact your previous supervisor forar reference?  YES D NO D  Company Address JobTitle Responsibilities  Phone ( ) Supervisor $  Starting Salary  Ending Salary  $  From  To  Reason for Leaving  May we contact your previous supervisor fora a reference?  YES D NO D  Company Address Job7 Title Responsibilities  Phone Supervisor $  )  Starting Salary  Ending Salary  $  From  To  Reason for Leaving  May we contact your previous supervisor forar reference?  YES 3  NO D    WRIGHTSVILLE BOROUGH EMPLOYMENT APPLICATION  MILITARYSERVICE Branch Rank atl Discharge Ifother than honorable, explain  From Type of Discharge  To  DISCLAIMER, AND: SIGNATURE may resulti ini my release. Signature  Icertify that mya answers: aret truea and complete tot thel best oft my knowledge.  Ifthisa application! leadst to employmenclundertand that false or misleading information ini my application ori interview  Date