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Please list any specialized skills, technical knowledge, or training you possess that may be applicable to the position you are
applying for. Include any software, machinery, or equipment you are able to use.
I authorize any person or organization listed in this application and/or whose name I have given as a character
reference and/or by whom I have been previously employed and/or any educational institution I have listed on this
application to furnish any information they may have concerning me to the City of Keene. I understand that the
information provided by me may be used for the purpose of determining eligibility. My previous employers may
be contacted, unless otherwise noted by me on this application or in writing. I hereby release, indemnify, and hold
harmless any governmental entity, employer, and person furnishing or receiving records and information about me.
By typing your name into this section, you are signing this agreement electronically. You agree that your electronic
signature is the legal equivalent of your manual signature on this agreement. You consent to be legally bound by
this agreement’s terms and conditions. You further agree that your use of a keypad, mouse, or another device to
select an item, button, icon, or similar act/action is acceptance and agreement as if actually signed by you in
The City of Keene requires that all employees have a valid driver license and must maintain a satisfactory
To assist the City of Keene in obtaining and evaluating your background, please provide the following information.
Thank you for completing this application form and for your interest in working with the City of Keene. We base all hiring decisions on merit
alone. The City of Keene is an equal opportunity employer. In accordance with the Civil Rights Acts of 1964 and 1991, as amended, the Age
Discrimination in Employment Act, and the Americans with Disabilities Act, the City of Keene shall not discriminate against any employee or
applicant for employment because of age, sex, national origin, religion, race, disability, or any other reason prohibited under Federal, State, or
local laws. Although this information is optional, we would appreciate your supplying the information requested.
Please note: this information will be used for statistical reporting purposes only. It will be separated from your application and will not be used in
any way in evaluating your qualifications for employment nor will it become a part of your file if you are not hired.
Typing your name into this section, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of
your manual signature on this Agreement. You consent to be legally bound by this Agreement's terms and conditions. You further agree that your
use of a keypad, mouse or another device to select an item, button, icon or similar act/action is acceptance and agreement as if actually signed by
you in writing.
This field is not part of the form submission.
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