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Wildwood Crest

Borough of Wildwood Crest
6101 Pacific Avenue
Wildwood Crest, NJ 08260
(609) 522-5176

Employment Application:
Applicant Information:
Date:
* Name (Last, First, Middle):
Address:
City/Town:
Phone (Work):
Home:
Social Security Number:
Position applied for:
Have you ever applied to the (local unit type) before: Yes No
If yes, give date:
Date you can start:
Salary desired:
Are you available to work: Full time   Part time   Shift work   Temporary
Are you currently employed: Yes No
May we contact you at work: Yes No
May we contact your current employer: Yes No
Are you currently on layoff status and subject to recall: Yes No
Do you possess a current driver’s license: Yes No
Do you possess a current commercial driver’s license: Yes No
Please list any endorsements:
THE BOROUGH OF WILDWOOD CREST IS AN EQUAL OPPORTUNITY EMPLOYER M/F
If you are under eighteen years of age, can you provide proof of eligibility to work: Yes No
Are you legally eligible to work in the United States of America: Yes No
Pursuant to Federal Law, proof of US Citizenship or immigration status will be required if you are hired.

Note to Applicants: PLEASE NOTE YOU MUST READ AND UNDERSTAND THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING BEFORE ANSWERING THE QUESTION BELOW:

Can you perform the essential functions of the job for which you are applying either with or without a reasonable accommodation?
Yes No

Employment History: This section must be completed even if you attach a resume. List your last four employers, major assignments within the same employer. Begin with the most recent. Include any military service. Explain any gaps in employment in the space on this form marked comments located on the bottom of this page.
Employer:
Date started:
Date left:
Work performed/ responsibilities:
Address:
Job Title:
Starting Salary:
Final Salary:
Reason for leaving:
Supervisor's name and phone number:
May we contact for a reference: Yes No
Employer:
Date started:
Date left:
Work performed/ responsibilities:
Address:
Job Title:
Starting Salary:
Final Salary:
Reason for leaving:
Supervisor's name and phone number:
May we contact for a reference: Yes No
Employer:
Date started:
Date left:
Work performed/ responsibilities:
Address:
Job Title:
Starting Salary:
Final Salary:
Reason for leaving:
Supervisor's name and phone number:
May we contact for a reference: Yes No
Employer:
Date started:
Date left:
Work performed/ responsibilities:
Address:
Job Title:
Starting Salary:
Final Salary:
Reason for leaving:
Supervisor's name and phone number:
May we contact for a reference: Yes No
Comments:
Education: Provide information on your formal schooling and education. Include elementary, secondary, and post-secondary education, if any. Include any formal vocational or professional education. For high school and post-secondary education, indicate any major or specialty, such as Academic, Business, or Trade.
School: Years completed:
(Circle)
Graduated:
(Circle)
Major Field:
High: 1 2 3 4 Yes No
College: 1 2 3 4 Yes No
Other: 1 2 3 4 Yes No
Languages: List any foreign languages you know and indicate your level of proficiency.
Language: Speak Some: Speak Fluently: Read: Write:

Special Skills & Experience: State any special skills, experience, training, licenses, certifications or other factors that make you especially qualified for the position for which you are applying.
Comments & Additional Information: Is there any additional information about you we should consider?
References: Provide the names, addresses and phone numbers of three people whom we may contact as a reference. They should not be relatives or former supervisors
Name & Address: Phone Number: Years Known:
Understandings and Agreements:
As an applicant for a position with the Borough of Wildwood Crest, I understand and agree that I must provide truthful and accurate information in this application. I understand that my application may be rejected if any information is not complete, true and accurate. If hired, I understand that I may be separated from employment if the Borough later discovers that information on this form was incomplete, untrue, or inaccurate. I give the Borough the right to investigate the information I have provided, talk with former employers (except where I have indicated they may not be contacted). I give the Borough the right to secure additional job-related information about me. I release the Borough and its representatives from all liability for seeking such information. I understand that the Borough is an equal-opportunity employer and does not discriminate in its hiring practices. I understand that the Borough will make reasonable accommodations as required by the Americans with Disabilities Act. I understand that, if employed, I may resign at any time and that the Borough may terminate me at any time in accordance with its established policies and procedures. No representatives of the Borough may make any assurances to the contrary. I understand that any offer of employment may be subject to job-related medical, physical, drug, or psychological tests. I also understand that some positions may involve complete background and criminal checks. For your application to be considered, you must sign and date below.
Applicant's Signature:
Date:
Voluntary Affirmative Action Information
You are not required to provide this information. Provide only if you wish.
If you provide information on this page, it will be filed separately from the job application.
This information will be used only for purposes of the affirmative action program
Applicant Information:
Name:
Address:
City/town:
Phone:
Position Applied For:
How did you learn about this position? Advertisement   Employment Agency
Friend   Relative   Walk-in   Other (Explain)
Information Regarding Status:
Gender: Male Female
Equal Employment Opportunity identification groups:
White
African-American (non-Hispanic)
Hispanic
American Indian/Alaskan native
Asian/Pacific Islander
Other
Other protected Groups:
Individual with a disability
Vietnam-era veteran (served between 1964 and 1975)
Disabled veteran

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IT'S BETTER IN THE CREST

BOROUGH OF WILDWOOD CREST | 609-522-5176
6101 PACIFIC AVENUE, WILDWOOD CREST, NJ 08260
OFFICE HOURS
MONDAY - FRIDAY | 9:00 AM - 4:30 PM
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