General Employment Application

Bedford Employment Application

Application for Employment

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion, handicap or national origin.

Date(Required)

Personal Information

Name(Required)

First Middle Last

Present Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Permanent Address (if different than above)

Complete address including City, State & Zip Code

Phone(Required)

Email(Required)

Are you 18 years of age or older?(Required)

Referred By:

Employment Desired

Position Interested:(Required)

Date You Can Start(Required)

Salary Desired:

Are you employed currently?(Required)

Have you ever worked with us before?(Required)

Type of Employment Desired(Required)

Employment History

Please list your current or most recent employer first

Employer / Company Name(Required)

Employer Address(Required)

Complete address including City, State, Zip Code

Dates of Employment(Required)

Position(Required)

Reason for leaving(Required)

Employer / Company Name

Employer Address

Complete address including City, State, Zip Code

Dates of Employment

Position

Reason for leaving

Employer / Company Name

Employer Address

Complete address including City, State, Zip Code

Dates of Employment

Position

Reason for leaving

Education

High School or Equivalency(Required)

Name of school / program

High School Location / GED Program(Required)

City & State

# of years completed(Required)

Diploma achieved(Required)

College

Name of school

College Location

City & State

# of years completed

Diploma

Trade / Vocational School

Name of school

School Location

City & State

Certificate completed

Field of study

General Information

Exclude organizations with the name of which may indicate race, sex, color or national origin of its members

Related Skills(Required)

i.e. Drivers License, Typing, etc.

Activities (other than religious)

i.e. civic, athletic, etc.

Please list any special job-related skills, certifications, and qualifications acquired from education, employment, volunteer work, or military service, which you feel, may be helpful in considering your application.

Resume Upload

Max. file size: 512 MB.

References

List three persons below (not related to you) whom you have known at least one year

Name

Phone

How acquainted

Coach, manager, neighbor, friend

Name

Phone

How acquainted

Coach, manager, neighbor, friend

Name

Phone

How acquainted

Coach, manager, neighbor, friend

Authorization(Required)

I agree to the terms

I certify that the facts contained in this application (and accompanying resume) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the Company.

I understand that my employment is conditioned on a complete background check. I hereby authorize the City of Bedford to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the City of Bedford, without giving me prior notice of
such disclosure. I release the City, any former employers and all references listed above from any and all claims, demands or liabilities
arising out of or related to such investigation or disclosure.

I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment
contract. I further understand and agree that if I am hired, my employment will be “at will” and without fixed term, and may be terminated
at any time, with or without cause and without prior notice, at the option of either myself or the City of Bedford. No promises regarding
employment have been made to me, and I understand that no such promise or guarantee is binding upon the City unless made in writing.

If I am offered employment, I agree to submit to a medical examination and drug test before starting work. If employed, I also agree to
submit to a medical examination or drug test at any time deemed appropriate by the City of Bedford and as permitted by law. I consent to
such examinations and test, and I request that the examining doctor disclose to the City the results of the examination, which results shall
remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent
permitted by law, is contingent upon satisfactory medical examinations and drug test, and if I am hired a condition of my employment will
be that I abide by the City’s Drug and Alcohol Policy.

I understand that filling out this form does not indicate there is a position open and does not obligate the City of Bedford to hire. If hired, I
agree to abide by all company rules, policies and procedures, in whole or in part, at any time.

If hired, I understand I will be required to attest to my identity and employment eligibility and will need to present documents confirming my identity and employment eligibility with the understanding that I cannot be hired if I cannot comply with these requirements.

Applicant Name(Required)

Date(Required)