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Application Submitted & Confidential Applicant Data Record

4. 

6. Thank you for submitting your Application for Employment!
   Thank you for your interest in employment with the Town of Wilbraham. Your application has been received and will receive due consideration during the selection process. You will be contacted as to the status of your application as the process continues.

   Thank you for your interest in employment with the Town of Wilbraham. Your application has been received and will receive due consideration during the selection process. You will be contacted as to the status of your application as the process continues.

10. CONFIDENTIAL APPLICANT DATA RECORD
    This Information is Voluntary

    This Information is Voluntary

12. The Town of Wilbraham (the “Town”) is an Equal Opportunity employer. Applicants are considered for all employment positions in the Town, and employees of the Town are treated during employment without regard to race, sex, color, handicap, national origin, military status, religion, age (as defined by law), ancestry, sexual orientation (as defined by law), pregnancy, and genetic information consistent with federal and state law.

    The Town of Wilbraham (the “Town”) is an Equal Opportunity employer. Applicants are considered for all employment positions in the Town, and employees of the Town are treated during employment without regard to race, sex, color, handicap, national origin, military status, religion, age (as defined by law), ancestry, sexual orientation (as defined by law), pregnancy, and genetic information consistent with federal and state law.

14. We invite you to indicate your gender and race/ethnicity or veteran status below. This information will be kept in a confidential file, separately from your application and will be used only in government reporting in accordance with federal and state regulations.

    We invite you to indicate your gender and race/ethnicity or veteran status below. This information will be kept in a confidential file, separately from your application and will be used only in government reporting in accordance with federal and state regulations.

16. YOU ARE NOT REQUIRED TO PROVIDE THIS INFORMATION. Your application for employment will be considered in the same manner whether or not you fill out this form.

    YOU ARE NOT REQUIRED TO PROVIDE THIS INFORMATION. Your application for employment will be considered in the same manner whether or not you fill out this form.

18. Position(s) applied for

19. Date
    Date

21. How did you hear about this opening?

23. Gender

    1. Female

    1. Male

25. Race/Ethnic Group

    1. White
    2. Black
    3. Hispanic
    4. Cape Verdean

    1. American Indian/Alaskan Native
    2. Asian/Pacific Islander
    3. Other

27. If Other, please list

29. Veteran Status

    1. Veteran

    1. Disabled Veteran

Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field