Form Center

What Position are you applying for?

Delhi Charter Township is an equal opportunity employer and will not discriminate against any applicant on the basis of race, color, religion, creed, gender, national origin, age, disability, marital status, sexual orientation, gender identity/expression, genetic information or any other legally protected status under state or federal law.
Please complete this employment application in its entirety; do not leave any blanks.
Position Applying For:*
Continue

Applicant Contact Information

First Name*
Last Name*
Middle Initial*
Email Address*
Address*
City*
State*
Zip Code*
Phone Number*
Best time to contact you*
Continue |Go Back

Other Applicant Information

Current Employer

Are you currently employed?*
1. Yes
2. No
Current Salary*
May we contact your current employer?*
1. Yes
2. No
3. NA
If yes, name of supervisor
Supervisor phone
Supervisor email
Continue |Go Back

Work Experience

Current/Most Recent Work Experience
Employer
Employer Address
City
State
Zip Code
Job Title
Supervisor
May We Contact?
1. Yes
2. No
Phone Number
Dates Employed
Reason for Leaving
Work Performed
Previous Work Experience
Employer
Employer Address
City
State
Zip Code
Job Title
Supervisor
May We Contact?
1. Yes
2. No
Phone Number
Dates Employed
Reason for Leaving
Work Performed
Other Work Experience
Employer
Employer Address
City
State
Zip Code
Job Title
Supervisor
May We Contact?
1. Yes
2. No
Phone Number
Dates Employed
Reason for Leaving
Work Performed
Continue |Go Back

Other Skills and Qualifications

List specific skills or training you may possess for the job in which you are applying.
List any equipment, machinery or computer skills/programs that you have used.
List any additional information or qualifications you feel will be helpful to us in considering your application.
Continue |Go Back

Education

High School Education
Name of High School*
Course of Study*
Number of Years*
Diploma?*
1. Yes
2. No
College Education
Name of College
Course of Study
Number of Years
Diploma?
1. Yes
2. No
Graduate/Professional Education
Name of School/Program
Course of Study
Number of Years
Diploma?
1. Yes
2. No
Continue |Go Back

References

Professional References (Please list three)
Name
Occupation
Phone
Years Known
Name
Occupation
Phone
Years Known
Name
Occupation
Phone
Years Known
Continue |Go Back

Resume/Documents Upload

Upload your resume or other documents
Continue |Go Back

Emergency Contact

Emergency Contact Name*
Emergency Contact Address*
Emergency Contact Phone*
Continue |Go Back

Applicant's Statement

APPLICANT’S STATEMENT:
Please read the following statement carefully before signing to indicate your understanding:
I certify that the information provided in this application is true and complete to the best of my knowledge. I agree and understand that any false information, misrepresentations, or omissions may disqualify me from further consideration for employment, or if employed, may result in discipline or termination from employment. I authorize Delhi Charter Township to investigate all statements contained in this application, including records of any former employers, police agencies, and other references or sources concerning me. I further authorize the references listed above and my former and/or current employer(s) to release to Delhi Charter Township any and all information concerning my previous or current employment and any pertinent information that they may have, personal or otherwise, and release all parties from all liability for any damages or causes of action that may result from furnishing this information. I waive any written notice of the release of such records that may be required by state or federal law. Should I receive an offer of employment, I consent to a pre-employment physical and drug screen, if required, at no cost to me. I understand that this offer of employment may be contingent upon the results of the medical examination and drug screen. In consideration of my employment, I agree to conform to the rules and regulations of Delhi Charter Township. I understand that no person or representative of Delhi Charter Township has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the provisions and/or policies set forth by the Delhi Township Board.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature

Leave This Blank:

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

This field is not part of the form submission.
Submit | Go Back

Search Forms:

Delhi Township Employment Application- Firefighter/Paramedic

Steps

What Position are you applying for?

Applicant Contact Information

Other Applicant Information

Current Employer

Work Experience

Other Skills and Qualifications

Education

References

Resume/Documents Upload

Emergency Contact

Applicant's Statement

Contact Us

Quick Links

FAQs