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Muhlenberg Township Application for Employment

2. **THIS IS NOT THE POLICE DEPARTMENT APPLICATION**
   Muhlenberg Police Department job application

   THIS PAGE IS NOT FOR POLICE APPLICATIONS. You MUST use the following link to apply for the Muhlenberg Police Department. Your application will not be accepted if you use the standard form below.

4. An Equal Opportunity Employer
   Please Note: Complete all parts of the application by printing or typing. If you have no information to enter in a section, please write N/A. Return completed applications to:<br>Human Resources<br>Muhlenberg Township<br>210 George Street<br>Reading, PA 19605

   Please Note: Complete all parts of the application by printing or typing. If you have no information to enter in a section, please write N/A. Return completed applications to:
   Human Resources
   Muhlenberg Township
   210 George Street
   Reading, PA 19605

6. First Name

7. Middle Name

8. Last Name

10. Address

12. City

13. State

14. Zip Code

16. Temporary Address

18. City

19. State

20. Zip Code

22. Cell Phone

23. Evening Phone

24. Email Address

26. Are you 18 years of age or older?

    1. Yes

    1. No

27. Do you have relatives currently working for Muhlenberg Township?

    1. Yes

    1. No

29. If Younger Than 18, List Birth Date
    If Younger Than 18, List Birth Date

30. List Department

32. Employment Desired

    1. Full Time
    2. Part Time
    3. Seasonal

33. Position Applied For

35. Can you perform the essential functions of the position that you are applying for?

    1. Yes

    1. No

36. Date You Are Available
    Date You Are Available

38. Are you employed now?

    1. Yes
    2. No

39. Do you object to working overtime?

    1. Yes
    2. No

40. Can you work overtime without prior notice?

    1. Yes
    2. No

44. Education & Training History

46. High School Address

48. City

49. State

50. Zip Code

52. Year Diploma or GED Was Received

    Graduation year is used for verification purposes only.

53. Mark the Highest Level of Education Completed

    1. Some High School
    2. High School/GED
    3. Associate

    1. Bachelor
    2. Master
    3. Doctoral

55. College/University Attended

56. Major Course of Study

57. Degree (if Any) and Year Received

59. College/University Attended

60. Major Course of Study

61. Degree (if Any) and Year Received

63. College/University Attended

64. Major Course of Study

65. Degree (if Any) and Year Received

67. Other Education Completed/Certifications, Licenses, Etc.

    The information provided should directly relate to the duties of the position for which you are applying.

69. Do you have a valid driver’s license?

    1. Yes

    1. No

70. Do you have a valid Commercial Driver’s License?

    1. Yes

    1. No

72. State & Expiration Date

76. Have you served in the U. S Armed Forces, including the U.S. Reserve or State Guard?

    1. Yes

    1. No

78. Branch

79. Date Entered
    Date Entered

80. Date Discharged
    Date Discharged

82. Highest Rank

83. Nature of Duties & Responsibilities

85. Do you claim Veteran’s Preference?

    1. Yes

    1. No

87. Note: If you claim Veteran’s Preference, attach a copy of discharge or separation papers (DD214).

88. Uploads

92. Employment Record
    List your previous four employers, starting with the most recent one first.

    List your previous four employers, starting with the most recent one first.

94. May we contact your past Employers?

    1. Yes

    1. No

95. May we contact your present Employer?

    1. Yes

    1. No

97. Company Name

98. Position/Title

100. Address

102. City

103. State

104. Zip Code

106. Start
     Start

107. End
     End

108. Wage/Salary

109. Telephone

111. Supervisor

112. Reason for Leaving

114. Major Duties

118. Company Name

119. Position/Title

121. Address

123. City

124. State

125. Zip Code

127. Start
     Start

128. End
     End

129. Wage/Salary

130. Telephone

132. Supervisor

133. Reason for Leaving

135. Major Duties

139. Company Name

140. Position/Title

142. Address

144. City

145. State

146. Zip Code

148. Start
     Start

149. End
     End

150. Wage/Salary

151. Telephone

153. Supervisor

154. Reason for Leaving

156. Major Duties

158. Professional References
     Provide the names and requested information for three persons not related to you, who have known you for at least one year who would know your qualifications and/or character.

     Provide the names and requested information for three persons not related to you, who have known you for at least one year who would know your qualifications and/or character.

160. First Name

161. Last Name

163. Address

165. City

166. State

167. Zip Code

169. Phone Number

170. Relationship

171. Years Acquainted

175. First Name

176. Last Name

178. Address

180. City

181. State

182. Zip Code

184. Phone Number

185. Relationship

186. Years Acquainted

190. First Name

191. Last Name

193. Address

195. City

196. State

197. Zip Code

199. Phone Number

200. Relationship

201. Years Acquainted

203. Have you ever plead no contest, plead guilty, or been found guilty of a misdemeanor or felony offense?

     1. Yes

     1. No

205. Provide dates and nature of offense(s), place of occurrence, and the name and address of the police department or court involved. A criminal record will not necessarily disqualify an applicant from employment.

207. Has your driver’s license ever been suspended?

     1. Yes

     1. No

209. For what reason?

213. Applicant’s Pre-Employment Agreement
     Applicant: Please read carefully before signing this application.<br><br> I understand that submission of an application does not guarantee employment. I further understand that employment obtained with Muhlenberg Township is employment at will unless otherwise stated in a collective bargaining agreement, for no specified duration and may be terminated either by the Township or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, statements of Muhlenberg Township representatives used during the employment process is deemed a contract of employment real or implied.<br><br> In consideration for employment with Muhlenberg Township; if employed, I agree to conform to the rules, regulations, policies and procedures. I understand that if offered a position, I may be required to submit to a pre-employment medical examination, drug screening and background checks as a condition of employment. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-employment checks will result in my withdrawal of any employment offer or termination of employment if already employed.<br><br> I understand that I will be required to provide documentation of identity and employment eligibility prior to starting employment as required by the Immigration Reform and Control Act of 1986.<br><br> I certify that, to the best of my knowledge and belief, all of the information on and attached to this application is true, correct, complete and made in good faith. I understand that false or fraudulent information on or attached to this application may be grounds for not hiring me or for firing me after I begin work, and may also be punishable by law. I understand that any information I give may be investigated and I release all parties involved from any and all liability for any and all damage that may result from providing such information.<br><br> By signing, I acknowledge that I understand and agree to the above statements.

     Applicant: Please read carefully before signing this application.
     
     I understand that submission of an application does not guarantee employment. I further understand that employment obtained with Muhlenberg Township is employment at will unless otherwise stated in a collective bargaining agreement, for no specified duration and may be terminated either by the Township or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, statements of Muhlenberg Township representatives used during the employment process is deemed a contract of employment real or implied.
     
     In consideration for employment with Muhlenberg Township; if employed, I agree to conform to the rules, regulations, policies and procedures. I understand that if offered a position, I may be required to submit to a pre-employment medical examination, drug screening and background checks as a condition of employment. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-employment checks will result in my withdrawal of any employment offer or termination of employment if already employed.
     
     I understand that I will be required to provide documentation of identity and employment eligibility prior to starting employment as required by the Immigration Reform and Control Act of 1986.
     
     I certify that, to the best of my knowledge and belief, all of the information on and attached to this application is true, correct, complete and made in good faith. I understand that false or fraudulent information on or attached to this application may be grounds for not hiring me or for firing me after I begin work, and may also be punishable by law. I understand that any information I give may be investigated and I release all parties involved from any and all liability for any and all damage that may result from providing such information.
     
     By signing, I acknowledge that I understand and agree to the above statements.

215. Signature of Applicant

216. Date of Signing
     Date of Signing

218. Muhlenberg Township is an equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, gender, age, marital status, veteran eligibility, disability, national origin, or any other legally protected status. No question on this application is asked for the purpose of disclosing any applicant’s legally protected status. Applicants requiring accommodation in the application or hiring process should contact the Human Resources Administrator.

     Muhlenberg Township is an equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, gender, age, marital status, veteran eligibility, disability, national origin, or any other legally protected status. No question on this application is asked for the purpose of disclosing any applicant’s legally protected status. Applicants requiring accommodation in the application or hiring process should contact the Human Resources Administrator.

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220. 1. Receive an email copy of this form.
221. Email address

     This field is not part of the form submission.

222. Submit Submit and Print

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