TOMPKINS COUNTY APPLICATION FOR EMPLOYMENT


Title of Position: .
Applicant's Name: .
Length of Employment
Firm Name Address City/State/Zip
FROM: Mo. Yr.  . . .
TO: Mo. Yr.  Type of Business Your Title Supervisor's Name
TOTAL: Yrs. Mo.  . . .
HOURS WORKED PER WEEK: 
 

 

Duties: 
Length of Employment
Firm Name Address City/State/Zip
FROM: Mo. Yr.  . . .
TO: Mo. Yr.  Type of Business Your Title Supervisor's Name
TOTAL: Yrs. Mo.  . . .
HOURS WORKED PER WEEK: 

 

Duties: 
CONSTITUTIONAL OATH 
(Signing the constitutional oath is required for appointment)
I do hereby pledge and declare that I will support the Constitution of the United States and the Constitution of the State of New York, and that I will faithfully discharge the duties of the position specified on this application according to the best of my ability.
AFFIRMATION AND RELEASE 
I affirm under the penalty of perjury that the statements made on this application (including any attachments) are true. I authorize the Commissioner of Personnel of Tompkins County, or his/her representatives, to obtain from all persons, schools, companies, corporations, credit bureaus and law enforcement agencies any records, documents and other information relative to my suitability to perform the duties of the position and I further release all parties supplying said information from all liability and responsibility arising from their supplying said information.

 
Signature______________________ Date_______ Signature______________________ Date_______

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