Employment Application

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CURRENT JOB OPENINGS: None at this time


Welcome to Hartsgrove Township's Online Employment Application.  Please fill out the requested information below. If you need assistance filling out this application form or any phase of the employment process, please contact, Pat Neuberger, Fiscal Officer at hartsgrove@ncweb.com, or by phone at (440) 474-4114 during normal hours. We will make every effort to accommodate the needs of our applicants.

This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. False information on this form, or during the interview process is grounds for terminating the application process or, if discovered after employment, terminating employment.

All applicants will receive consideration without discrimination because of sex, marital status, race, age, creed, national origin or the presence of disabilities. After an offer of employment, you may be required to submit to a drug test and medical review. Depending on the policy and the needs of the job, you may be required to complete a medical history form and may be required to be examined by a medical professional designated by Hartsgrove Township, Ohio, if applicable.

* Required Fields     -  
Personal Information
 











Job Selection, Availability & Resume
 






EQUAL OPPRTUNITY EMPLOYER
Contact Info & Previous Address
 



, (if less than 5 yrs.)
 



, (if less than 5 yrs.)

License Information
 



1000 Characters Remaining
 
  

Have you used any names, or Social Security numbers other than given above? If so, please list. *
 
Yes   No  
1000 Characters Remaining
Education Information
 

YES      NO
 

 

YES      NO
 
Employment Information


Please enter the information for each employer. We make every effort to contact previous employers that you have selected. Correct phone numbers are critical.
 
 
 
 

YES      NO
 












1500 Characters Remaining
 

 
 
 
 

YES      NO
 












1500 Characters Remaining
Personal References
 
Include only individuals familiar with your work ability. Please do not include relatives.

Reference 1
Phone No.

Address (City, State)
Years
Relationship

Reference 2
Phone No.

Address (City, State)
Years
Relationship



Certification of Application
 
I certify that I have read and understand the applicant information above and the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge. I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize Hartsgrove Township, Ohio, and/or its agents, including consumer reporting bureaus, to verify any information. I authorize all former employers, persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforecement authorities from any liability for any damage whatsoever by issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment, as necessary.
 
 


 
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HARTSGROVE TWP., OHIO - 5321 STATE ROUTE 534, ROME, OH 44085 - (440) 474-4114


Form 2203-10-001.1

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