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Equal Employment Policy
We welcome you as an applicant for employment with the Village of Bensenville. Your application will be reviewed without regard to race, color, religion, sex, age, national origin or disability. All information contained in or connected with this application will be considered personal and confidential and used only in conjunction with your possible employment by the Village of Bensenville. Please furnish us with complete information as outlined in this application. Falsifying information may be grounds for disqualification or dismissal.
The Village of Bensenville is proud to be an Equal Opportunity Employer. Persons requiring reasonable accommodations under the Americans with Disabilities Act are asked to contact the Human Resources Department at 630.350.3401.
Date
Date
Referral Source:
If Referred by Other or Village Employee, provide details:
First Name*
Middle Intial
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Have you filed an application here before?*
1. Yes
1. No
Have you been employed here before?
1. Yes
1. No
If above answer(s) are Yes, please give start date.
If above answer(s) are Yes, please give start date.
End date
End date
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?*
1. Yes
1. No
Are you related to anyone currently employed by the Village?
1. Yes
1. No
If so, please give name, department and relationship
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Which position are you applying for?*
Do you have a valid driver's license?*
1. Yes
1. No
On what date would you be available for work?*
On what date would you be available for work?
Type of employment desired*
1. Full Time
2. Part Time
Hours of work (per week) desired*
Are you on a lay-off and subject to recall?*
1. Yes
2. No
Are you a Veteran of the U.S. Military Service?*
1. Yes
2. No
If yes, please list what branch:
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High School
Address
Select highest grade completed:
College
Address
Degree
Other
Address
Degree
List any correspondence courses, special courses, seminars, workshops, technical schools attended or any licenses or certifications that you hold that may relate to this position
List any skills you have that relate to this position:
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Please supply the names of three (3) personal references (not former employers or relatives):
Full Name*
Relationship*
Company*
Phone Number*
Full Name*
Relationship*
Company*
Phone Number*
Full Name*
Relationship*
Company*
Phone Number*
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EMPLOYMENT WITH THE VILLAGE OF BENSENVILLE IS ON AN ‘AT-WILL’ BASIS (i.e.: an employee may resign at any time and the Village may discharge the employee at any time without cause.)
After a satisfactory introductory period the employee shall qualify for the benefits accorded all other employees in the job description under which he or she has been employed.
I hereby authorize an investigation of all statements contained in this application. I certify that the statements made on this application are true and correct to the best of my knowledge and that I am aware that any falsification of this application is cause for rejection of application or termination of employment.
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
Applicant Signature*

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