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HomeMy Public PortalAboutElection-poll worker application 2020APPLICATION FOR ELECTION/POLL WORKER Town of Watertown, Massachusetts Personnel Office 149 Main Street Watertown, MA 02472 Thank you for your interest in employment with the Town of Watertown. INSTRUCTIONS: Each question should be fully and accurately answered. Please PRINT or TYPE, except for your signature on the back of the application. GENERAL Position applying for: ELECTION/POLL WORKER Date of application: _________________ Referral source: Newspaper ad Online ad Employee Relative Bulletin Board_____ (check one) Walk – in Employment agency School Town Website Other ______ Name of source (if applicable): Date available for work: ______________________ PERSONAL Name: (First) (Middle) (Last) ___________________________ Address: (Street) ____________________________________ (City) (State) (Zip) ___________ Telephone: Home ( ) ______________________ Cell ( ) _______________________ Between 8:30 a.m. and 4:30 p.m. ( ) ________________________ If this is your current place of employment, may we contact you there? Yes No Email: ______________________________________________ Are you age 18 or older? Yes No If no, list the date of birth: _________________________ Have you worked for the Town of Watertown before? Yes No If yes, list: (dept.) ________________ Dates of service: From: _________________ To: _________________ Briefly explain why you would like to be considered: REFERENCES Please exclude former employers or relatives. Name and occupation Address Phone 1) 2) OTHER INFORMATION Are you able to provide documented proof of U.S. citizenship or valid work permit as required upon employment to work in the United States? Yes No Signature: Date: