Application For Employment

Town of Mansfield, CT

The Town of Mansfield is an equal opportunity employer. The Town will not, except in the case of a bona fide occupational qualification or need or except as otherwise permitted by law, discriminate on the basis of race, color, religious creed, age, sex, marital status, sexual orientation, national origin, ancestry, present or past history of mental disability, mental retardation, learning disability or physical disability, with respect to hiring, compensation, promotion, discharge from employment or other terms and conditions of employment.

Directions for this Application (please read!)

Please complete all sections of this application in as much detail as possible. Before beginning a new section, read the directions carefully. The application is the first screening device in the recruitment process. The information contained in both the Education and Employment Experience sections of this application will be used to assess your qualifications for the position in question. Therefore, it is very important that you provide any and all information that will aid the Town in assessing your qualifications.

You will see a confirmation screen when you click the 'Submit Form' button. If you do not see this confirmation, please try again. If you see an error message instead of a confirmation, please contact us at webmaster@mansfieldct.org.

All formatting will be stripped from your application. This means that extra spacing, bullets, 'special' characters, and other formatting features will not be preserved after you submit your application and will not be seen by reviewers.

If you wish to apply for more than one job, please submit your application separately for each job. To save yourself from lots of typing, most browsers will allow you to hit the "Back" button at the confirmation screen, change the job selection, and then submit again. This is an ability of your web browser, not our application, and is not guaranteed to work.

You may not save a partial application. If you wish to work on the application in parts, we suggest typing it out in a word processor and cutting and pasting into the application when you are ready.

If you wish to apply for a job with the Mansfield School System, please go to the BOE Jobs page instead. Applicants interested in positions with Region 19 / E. O. Smith, please go to E.O. Smith’s website. The Town does not accept applications for either the Mansfield or Region 19 school systems.

Thank you for your interest in the Town of Mansfield.

Position You Are Applying For:

Go to Job Opportunities page (opens in new window)

Salutation
First Name Middle Initial Last Name
Street Address
City State Zip
Phone (Home) Phone (Daytime)
Email Address
 
Date You’re Available
I Am Requesting work

Are you a United States citizen or are you authorized to work in the United States?

(Proof of citizenship or authorization to work in the United States will be required upon hire.)

Do you have a valid Connecticut driver’s license? * 

* Answer ONLY if a driver’s license is REQUIRED FOR THE POSITION YOU SEEK.

Education

  High School College or University Graduate or Professional
School Name
Location
Years Completed
Specify Degree or Certification Received

(please indicate concentration area if applicable)

Do you have any Specialized Training, Apprenticeships, Skills, or Extra-Curricular Activities?

Briefly describe course work relevant to this position:

State any additional information you feel may be helpful to us in considering your application.

Employment Experience

Start with your current or most recent job. Include military service assignments and volunteer activities.

Employer 1:

Employer’s Name Supervisor
Job Title
Address
City State Zip
Hire Date Leave Date
Starting Salary or Wage Ending Salary or Wage
Work Performed
Reason for Leaving

Employer 2:

Employer’s Name Supervisor
Job Title
Address
City State Zip
Hire Date Leave Date
Starting Salary or Wage Ending Salary or Wage
Work Performed
Reason for Leaving

Employer 3:

Employer’s Name Supervisor
Job Title
Address
City State Zip
Hire Date Leave Date
Starting Salary or Wage Ending Salary or Wage
Work Performed
Reason for Leaving

Employer 4:

Employer’s Name Supervisor
Job Title
Address
City State Zip
Hire Date Leave Date
Starting Salary or Wage Ending Salary or Wage
Work Performed
Reason for Leaving

Employer 5:

Employer’s Name Supervisor
Job Title
Address
City State Zip
Hire Date Leave Date
Starting Salary or Wage Ending Salary or Wage
Work Performed
Reason for Leaving
 

References

Reference 1:

Name
Street Address
City State Zip
Employer Title
Phone Number

Reference 2:

Name
Street Address
City State Zip
Employer Title
Phone Number

Reference 3:

Name
Street Address
City State Zip
Employer Title
Phone Number
 

Criminal History Inquiries

"Conviction", for this application, means a final judgment or verdict of guilty, a plea of guilty, or plea of nolo contendere, in any state or federal court, regardless of whether an appeal is pending or could be taken. "Conviction" does not include a final judgment or verdict that has been expunged by pardon, reversed, set aside or otherwise rendered invalid. Further, you are not required to disclose any arrest(s), criminal charge(s) or conviction(s) the record(s) of which have been erased under law. Such records can include records of finding of delinquency or that a child was a member of a family with service needs (Conn. Gen. Stat. § 46b-146), adjudication of youthful offender status (Conn. Gen. Stat. § 54-76o), criminal charges dismissed or nolled, or charges for which a person is found not guilty or a conviction later resulting in an absolute pardon (Conn. Gen. Stat. § 54-142a).

Further, any person whose criminal records have been erased is deemed under law never to have been arrested with respect to such erased proceedings and may so swear under oath.

Should you have any questions about answering questions on this application, or your rights concerning erased records, please contact the Town Manager’s Office at (860) 429-3336

Have you ever been convicted of any offenses other than minor traffic violations?

If yes, please describe:

Please Tell Us How You Heard About This Position

Name and Date of Newspaper?
Web Site Address?
Where Posted?
Company?
Name of Organization?
Please describe...
 Friend
College Placement Office
Town Employee
Walk-in (no prior knowledge)
 

Equal Opportunity Employer

The Town of Mansfield is an Equal Opportunity Employer. Applicants are considered for all positions without regard to race, creed, color, religion, sex, national origin, sexual orientation, ancestry, age, marital, family or veteran status, past or present history of mental disorder, mental retardation, learning disability, or physical disability or handicap including but not limited to blindness.

Because the Town of Mansfield is committed to making a concerted effort to recruit qualified applicants from all of the above mentioned groups, we ask that you complete the following questions.

This information will be used solely for affirmative action and recruitment purposes, in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. Submission of this data is voluntary and refusal will not subject you to any adverse treatment. Although completing this information is voluntary, your cooperation will help us with mandated federal and state reporting, and with future recruiting. As required by the ADA and other applicable laws, this data will be kept confidential in an affirmative action file separate from your application.

Position(s) Applied For
Date of Birth
Gender
Race or Ethnic Group If Other, please fill in:
 
Are any of the following applicable? Veteran Veteran with a Disability Individual with a Disability
Please identify the nature of your disability, if you so choose:
 

Applicant’s Statement

I certify that all of the answers and statements contained in this application are complete, true and correct to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not and is not intended to be a contract of employment.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Town of Mansfield during the application process.

If you agree to the above statement, please select Yes: