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General Information
Education
Work Experience
Demographic Information
Application Type:
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Seasonal
Part Time
Full Time
Department:
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Division:
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Position Applied For:
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SSN:
First Name:
Last Name:
Middle Name:
Address:
Enter Address
City:
State:
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Zip Code:
Home Phone:
Cell Phone:
Email:
Are you a citizen of the United States or an alien authorized to work in the United States?
Are you 18 years of age or older?
DOB:
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(Complete only if younger than 18 years old)
Do you possess a valid NJ Driver's License?
Driver license#
Answer only if position applied for requires a driver's license
Do you have any relatives who work for County of Essex?
If yes, give the name, their relationship to you and Department in which they were employed
Name:
Relationship:
Department:
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Have you ever been Employed by the County of Essex?
If yes, when?
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Where?
select
 
Do you presently have a full time position that you intend to retain?
If yes, what are you days and hours of work?
Are you now or have ever been a member of local, state or federal retirement system?**
If yes, indicate system name
**This Information is optional. If you presently receiving a pension, it may effect your ability to be enrolled in pension plan.
List Languages, other than English, you speak and/or write fluently which you are willing to use during employement(include braille and sign language)
Speak:
Write:
Read:
Are you a veteran?
Branch
Highest Rank
Military Duties
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List any High Schools, Colleges, Universities, Business, Technical or Trade Schools you have attended
School
School Name & Location:
Did you graduate?
If no, give the highest grade completed
If you did not graduate, do you possess a High School Certification?
College
Name & Location:
Did you graduate?
Degree:
Major:
No of Credits:
Graduate
Name & Location:
Did you graduate?
Degree:
Major:
No of Credits:
Business or Trade School
Name & Location:
Did you complete program?
Degree:
Major:
Do you possess any special licenses, certificates, permits, or skills, or do you operate any machines or tools?
If Yes, explain
Explain Special Skills
Previous Employment
Previous Employment
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Previous Employment
Please list other experience, including volunteer work, relating to the position applied for:
References
Address
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Address
The COUNTY OF ESSEX is an Equal Employment Oppurtunity/Affirmative Action Employer and as such seeks to recruit and employ all individuals without regard to race, gender, age, color, national origin, ancestry, martial status, religion, military status, atypical cellular or blood trait, mental or physical handicap that with reasonable accomodation does not significantly intefere with the ability to perform the essential functions of the job. To ensure an adequate evaluation of our hiring policies as well as compliance with government regulations, the following information is requested,
but not required.
THE COUNTY OF ESSEX will not use this information to reach a hiring decision, nor will discriminate on the basis of this information.
DOB:
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Gender:
Martial Status:
Race: