BOARD MEMBERS AND CONTACT INFO
The Town Board meets on the 1st Monday of each month, unless it is a Holiday.
Town Chair: Jim Ferg 920-304-9569 jferg@highway.email
Supervisor 1: Aarich Curtis (715) 513-0054 amcurtis91@gmail.com
Supervisor 2: Bruce Cady 715-281-4611 brucecady@rocketmail.com
Clerk: 920-244-7431 lawrence@wolfnet.net
Treasurer: Michelle Oppor 608-575-8654 michelleotownhall@yahoo.com
Building Inspector: Paul Hanlon 920-878-0024
Assessor: Larry Preuss 920-244-7635 townassessor@wolfnet.net
Application for Employment Town Clerk -open for immediate start
Please print and fill out. Return to Town by email at lawrence@wolfnet.net
Town of St Lawrence
Application for Employment
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.
(PLEASE PRINT)
Position(s) Applied For
Date of Application
How Did You Learn About Us?
Advertisement Friend Walk-In
Employment Agency Relative Other _________________________________________
Last Name First Name Middle Name
Address Number Street City State Zip Code
Telephone Number(s):
(H)
(Cell)
Date of Birth: (for background check)
/ /
Drivers License Number (for background check)
Social Security Number (for background check)
- -
You are 18 years or older? Yes No
Have you ever filed an application with us before? Yes No
If Yes, give date ________________
Have you ever been employed with us before? Yes No
If Yes, give date ________________
Are you currently employed? Yes No
May we contact your present employer? Yes No
Are you prevented from lawfully becoming employed in this
country because of Visa or Immigration Status? Yes No
Proof of citizenship or immigration status will be required upon employment.
On what date would you be available for work? _________________
Are you available to work: Full Time Part Time Casual
Are you willing to work weekends? Yes No
Are you currently on “lay-off” status and subject to recall? Yes No
Can you travel if job requires it? Yes No
Have you been convicted of a felony within the last 7 years? Yes No
If yes, please explain _________________________________________________________
___________________________________________________________________________
Education
May substitute or include resume for education and job history sections
Name and Address of School
Course of Study
Years
Completed
Diploma
Degree
Elementary
School
High
School
Technical
College
University
or
College
Other
(Specify)
Describe any specialized training, apprenticeship, skills and extra-curricular activities.
Describe any job-related training received in the United States military.
Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status. If you need additional space, please continue on back or a separate sheet of paper
Employment Experience
.
Employer
Dates Employed
From To
Work Performed
Address
Telephone Number(s)
Hourly Rate/Salary
Starting Final
Job Title and Supervisor
Reason for Leaving
____________________________________________
Employer
Dates Employed
From To
Work Performed
Address
Telephone Number(s)
Hourly Rate/Salary
Starting Final
Job Title and Supervisor
Reason for Leaving
__________________________________________________________________________________________
List professional, trade, business or civic activities and offices held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status:
Additional Information
Other Qualifications
Summarize special job-related skills and qualifications acquired from employment or other experience.
Specialized Skills &/or Training
Additional information you feel may be helpful to us in considering your application.
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENT OF THE JOB FOR WHICH YOU ARE APPLYING.
Are you capable of performing in a reasonable manner the activities involved in the job or occupation for which you have applied? A description of the activities involved in such a job or occupation is available.
Yes No
Work Related References
(Name/Address) Contact information (phone # or email)
1.
(Name/Address) Contact information (phone # or email)
2.
(Name/Address) Contact information (phone # or email)
3.
All information is on this application to the best of my knowledge is truthful & accurate. I understand that if any information is found to be false or inaccurate that this application and/or eligibility for employment will be forfeited. If I receive and offer for employment and/or begin employment and false and inaccurate information is found, offer for employment will be removed or employment terminated. I do thereby allow the Town of St Lawrence to perform any and all background checks as they relate to employment and job expectations.
______________________________________________ ________________________________
Applicant Signature Date
Return or mail to:
Town of St Lawrence
Po Box 137
Ogdensburg, WI 54962
Lawrence@wolfnet.net
Revised 11/01/2024