Speedway Public Works Pre-Application Form

Speedway Public Works Pre-Application Form

 Step 1 of 1

 SPEEDWAY PUBLIC WORKS

APPLICATION FORM

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* Denotes a required field
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Date*
 Date

Personal Information

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ZIP*
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Second portion of ZIP Code is optional.
Phone Number*
-- ext
Are you at least 18 years of age?*
Do you have any friends or relatives employed by the Town of Speedway? 
 
 
$
Available Start Date*
 Available Start Date

The Immigration Reform and Control Act of 1986 requires us to inspect documents verifying the identity and employment eligibility of all new hires

Are you legally authorized to work in the United States?*
Have you ever been convicted of a crime? (other than a traffic misdemeanor)*
 

Have you ever served in the Armed Forces of the United States? If yes, please answer the following:

 
 
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Select below what type of employment hours you are applying for.

Employment Hours*
Have you ever been employed by the Town of Speedway?*
 

For applications applying for positions involving driving a municipal owned vehicle

Do you have a valid Indiana drivers license?*
*
 
 
 

Education

Please list - 1) Name of School 2) Major or Area of Study 3) Diploma, Degree or Certificate obtained
 
 
 
 
 

Business, Educational or Professional References: Previous Supervisors Preferred

Please list the Name, Company, Telephone and Years known for references listed
 
 

Employment History starting with present or most recent

Please list Company Name and Address, Telephone, Dates of Employment, Salary , Job Description or Duties
 
May we contact? 
 
May we contact? 
 
May we contact? 
I certify that information provided in this application is true and complete. I understand that if I have provided false or misleading information I will be disqualified for consideration, and if hired can be subject to discharge. I authorize the Town of Speedway to contact my present and former employees for verification of information I provided in this application unless indicated above. I hereby release the Town of Speedway from any liability for any damages that could result from furnishing information provided in the application. I understand that the Town of Speedway may require me to take a pre-employment drug screening test as a condition of employment and if I refuse or fail the screening test I will be disqualified for consideration for employment.
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To certify your application, provide an electronic signature (type your name in field provided above).
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Contact Us

1450 N Lynhurst Dr
Speedway, IN 46224
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