2000 South Central Ave, Marshfield, WI 54449

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MARSHFIELD UTILITIES

APPLICATION FOR EMPLOYMENT

We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job related medical condition or handicap/disability or any other legally protected status. Marshfield Utilities is an Equal Opportunity Employer.

Fields with ( ) are required. If using a keyboard, press the Tab key to advance through each field.

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Yes    No
 (If yes enter dates and dept.)


Have you any relatives or friends in our employ?


EDUCATION

Elementary School

High School

Night School

College Or University

Graduate School




FORMER EMPLOYERS

List below all previous employers starting with your most recent employment first. If you are now working, present employer and reason for desire to quit must be included. Also give reason for lapse of time where a period of termination of one place of employment does not fit into the next place of employment.

Former Employer 1



Former Employer 2



Former Employer 3



Former Employer 4





AUTHORIZATION AND ACKNOWLEDGEMENT FOR EMPLOYMENT

I certify that the answers given by me in this application are true and correct without omissions of any kind. I understand that any misleading or incorrect statements may render this application void. If I am employed and it is subsequently discovered that any answer given by me is incomplete, misleading or incorrect, I may be terminated. I agree that Marshfield Utilities shall not be held liable in any respect if my employment is terminated because of false, incomplete or misleading statements, answers or omissions made by me in this application.

I also authorize pertinent companies, schools, agencies, municipalities or persons to give to Marshfield Utilities any information requested regarding my employment, character, experience and qualifications and/or suitability for employment with Marshfield Utilities including a check of my fingerprints and police record for the purpose of considering my suitability for hire. I hereby forever release, discharge and covenant not to sue any person or organization for any result of providing, obtaining or acting upon such information. I understand that such information is sought with confidentiality and will not be released to me in any form whatsoever.

In addition, a copy of this authorization is as valid as the original and should be recognized as such.

I further understand that I may be asked to undergo a physical examination, including substance abuse screening, prior to an appointment to a position with Marshfield Utilities. Refusal to participate will result in the rejection of my application.



Customers not wishing to complete the online application, may print the PDF version and fax, email, mail or bring to Marshfield Utilities office. Please remember processing will be delayed. Marshfield Utilities must have one business day to process a completed application, but only after it is received.

Download PDF Version