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Personal Information

An Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. The Borough of Phoenixville does not accept unsolicited applications. You will only be considered for the position which you are applying. A separate application must be completed for each position for which you are interested in applying.
Personal Information
Incomplete information could disqualify you from further consideration.
Last Name*
First Name*
Middle Initial*
Street Address*
City*
State*
ZIP*
Email Address*
Home Phone
Mobile Phone
Are you legally eligible to be employed in the United States?*
1. Yes
2. No
Are you 18 or older? *
1. Yes
2. No
If no, you may be required to provide authorization to work.
What position are you applying for?
How did you hear about this position?
1. Advertisement
2. Referral
3. Walk-in
4. Other
If other, please describe.
Desired Salary
Desired Hourly Rate
Date Available to Start
Date Available to Start
Date Available to Start
Are you currently employed?*
1. Yes
2. No
May we inquire of your present employer?*
1. Yes
2. No
Have you ever worked for the Borough of Phoenixville?*
1. Yes
2. No
Do you know anyone who works for the Borough of Phoenixville?*
1. Yes
2. No
Name*
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Employment History
Please include periods of unemployment, starting with the most recent and working backwards.

Incomplete information could disqualify you from further consideration
Current or Most Recent
Employer
Address
City
State
ZIP
Telephone
Name of Immediate Supervisor
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Position/Job Title
Summarize the nature of work performed and job responsibilities.
Reason for Leaving
May we contact this employer?
1. Yes
2. No
Employer
Address
City
State
ZIP
Telephone
Name of Immediate Supervisor
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Position/Job Title
Summarize the nature of work performed and job responsibilities.
Reason for Leaving
May we contact this employer?
1. Yes
2. No
Employer
Address
City
State
ZIP
Telephone
Name of Immediate Supervisor
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Position/Job Title
Summarize the nature of work performed and job responsibilities.
Reason for Leaving
May we contact this employer?
1. Yes
2. No
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Personal References
Please provide the names of three people not related to you whom you have know at least one year.
Name
Address
City
State
ZIP
Telephone
Email
Years Acquainted
Name
Address
City
State
ZIP
Telephone
Email
Years Acquainted
Name
Address
City
State
ZIP
Telephone
Email
Years Acquainted
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Upload Additional Documents Here*
Please submit a resume, as well as any other documents that you wish to submit with this application.
Please read carefully before signing.
“I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the Borough’s rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the Borough’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the Borough. I understand that no Borough representative, other than Borough Council President, and then only when in writing and signed by the President of Council, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”
Signature
Date
Date

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