Milford, DE - Official Website

Personal Information

First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
May we contact you via email?*
1. Yes
1. No
Are you 18 years of age or older?*
1. Yes
1. No
Are you eligible to work in the United States?*
1. Yes
1. No
Upon hire you will be required to provide proof of eligibility.
Have you previously been employed by the City of Milford?*
1. Yes
1. No
If yes, what position?
Dates:
Dates: Start Date
—
Dates: End Date
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Position Information

Which position are you applying for?*
Type of employment desired:*
1. Full Time
1. Part Time
1. Temporary
1. Internship
When are you able to begin employment?*
When are you able to begin employment?
Are any of your relatives employed with the City of Milford?*
1. Yes
1. No
If yes, what is their name?
Relationship?
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Education, Skills, Qualifications and Experience

Highest level of compulsary education completed:*
High School
Address
Highest level of higher education completed:
College/University/Trade School
Address
Degree/Diploma
Highest level of postgraduate education completed:
Postgraduate School
Address
Degree
Special training or skills of benefit to the position which you are applying:
For example: second language, machine operation, etc.
Do you possess a valid Driver's License?*
1. Yes
1. No
If yes, which class?
If you possess a Commercial Driver's License, what date does your Medical Examiner's Certificate expire?
If you possess a Commercial Driver's License, what date does your Medical Examiner's Certificate expire?
Has your Driver's License ever been suspended due to operating a vehicle under the influence of drugs or alcohol?*
1. Yes
1. No
Have you served in the U.S. Armed Forces?*
1. Yes
1. No
If yes, which branch?
Final Rank:
Reserve Status:
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Employment History

(From Most Recent)
Company
Position
Supervisor
Phone Number
Address
Responsibilities
Employed From - To
Employed From - To Start Date
—
Employed From - To End Date
Reason for Leaving
May we contact your most recent employer for a reference?
1. Yes
1. No
Company
Position
Supervisor
Phone Number
Address
Responsibilities
Employed From - To
Employed From - To Start Date
—
Employed From - To End Date
Reason for Leaving
Company
Position
Supervisor
Phone Number
Address
Responsibilities
Employed From - To
Employed From - To Start Date
—
Employed From - To End Date
Reason for Leaving
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References

Please list three professional references.
Full Name*
Company*
Position*
Phone Number*
Full Name*
Company*
Position*
Phone Number*
Full Name*
Company*
Position*
Phone Number*
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Equal Employment Opportunity Survey

Disclaimer & Signature

I certify that my answers are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that if hired I may be released from employment. I understand that the company may require me to successfully complete a pre-employment drug and alcohol test and a background check as a condition of employment and that continued employment may be based on the successful completion of similar tests. Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
I certify that my answers are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that if hired I may be released from employment.

I understand that the company may require me to successfully complete a pre-employment drug and alcohol test and a background check as a condition of employment and that continued employment may be based on the successful completion of similar tests.

Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
Applicant Signature*
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Criminal History Record Check

Last Name*
First Name*
Full Middle Name*
Date of Birth*
Date of Birth
Sex*
1. M
2. F
Race*
Alias/Other Name(s)
Social Security Number*
Driver's License Number or ID Number*
State*
Address*
Include Street, PO/Apartment Number, if applicable
City*
State*
Zip*
Phone Number*
Include area code
Have you ever been arrested, convicted or adjudicated delinquent of a crime? *
1. Y
1. N
If yes, explain:
By my signature below, I acknowledge that I have been informed that the Delaware Justice Information System will NOT permit me to access computers connected to their network if I have been convicted of a felony. I understand that access to the Delaware Criminal Justice Network is mandatory for the employment that I am seeking. I understand that the Milford Police Department will be conducting a thorough criminal history check through National Databases maintained by the Federal Bureau of Investigation to verify the absence of any felony arrest or arrests for crimes of dishonesty in ANY State or Territory of the United States. I hereby release the City of Milford, its agents, employees, and assigns from any and all liability for conducting this required inquiry into my criminal history and understand that the Milford Police Department will not release this information to anyone outside the law enforcement community. I also acknowledge that I am providing my social security number as a supplemental form of identification only. I also understand that information acquired through this process will be used to evaluate my eligibility for employment. Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
By my signature below, I acknowledge that I have been informed that the Delaware Justice Information System will NOT permit me to access computers connected to their network if I have been convicted of a felony. I understand that access to the Delaware Criminal Justice Network is mandatory for the employment that I am seeking. I understand that the Milford Police Department will be conducting a thorough criminal history check through National Databases maintained by the Federal Bureau of Investigation to verify the absence of any felony arrest or arrests for crimes of dishonesty in ANY State or Territory of the United States. I hereby release the City of Milford, its agents, employees, and assigns from any and all liability for conducting this required inquiry into my criminal history and understand that the Milford Police Department will not release this information to anyone outside the law enforcement community. I also acknowledge that I am providing my social security number as a supplemental form of identification only. I also understand that information acquired through this process will be used to evaluate my eligibility for employment.

Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
Signature*
Date*
Date

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