Job Application

 

 

BURLINGTON COUNTY BRIDGE COMMISSION

 

1300 ROUTE 73 NORTH, P.O. BOX 6
PALMYRA, NJ 08065-0006
TELEPHONE NO. 856-829-1900
FAX NO. 856-829-5205

 

APPLICATION FOR EMPLOYMENT

Contact Information

Select your proposed schedule
Name
Name
First
Middle
Last
Address
Address
City
State/Province
Zip/Postal

Applicant Information

High School

College

Additional Information

Previous Employment (Most Current First)

Supervisor Name
Supervisor Name
First
Last

Second Employer

Supervisor Name
Supervisor Name
First
Last

Third Employer

Supervisor Name
Supervisor Name
First
Last

References 1

Name
Name
First
Last

References 2

Name
Name
First
Last

References 3

Name
Name
First
Last

Military Services

Company Policies Acknowledgment

E-Signature Agreement

I understand and agree to each and all of the Terms and Conditions in this Burlington County Bridge Commission employment application Consent for Use of Electronic Signature Agreement. My electronic signature is legally binding.

I hereby give the Burlington County Bridge Commission the right to fingerprint me, and to make a thorough background investigation into my previous employment, criminal record, education and references; and I release from all liability all persons, companies, and corporations supplying such information. I release, indemnify, and hold harmless the Burlington County Bridge Commission from and against any and all liability which might result from making such an investigation. I further understand that as a part of the application and employment process I may be required to provide my social security number to the Bridge Commission and I agree to provide same.

I agree to submit to the Commission’s drug test, and I understand and agree that before the Commission will extend an offer of employment to me, I must successfully pass that test in accordance with the Commission’s policy.

I further understand and agree that if an offer of employment is made to me, if applicable, I agree to take a physical and psychological examination prior to the commencement of employment. I understand that any job offer is contingent on the successful completion of these medical examinations. The results of these examinations will be used in accord with, and in compliance with the Americans With Disabilities Act, 42 U.S.C. §12101 et seq. and other applicable law.

I understand that any false answer, statement, or representation made by me in this application shall constitute sufficient cause for discharge. I also understand that nothing contained in this employment application or granting of an interview is intended to create an employment contract between the Burlington County Bridge Commission and myself for either employment or for the granting of benefits. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Burlington County Bridge Commission unless made in writing. If an employment relationship is established, I understand and agree that it is not for a definite period of time and that I have the right to terminate my employment at any time and that the Burlington County Bridge Commission retains a similar right.

I understand that, if accepted for employment, it is necessary to abide by the rules and policies of the Burlington County Bridge Commission and that I will be on probation before being considered a regular employee.

Electronic Signature Agreement

By selecting the "E-Signature Agreement" checkbox, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "E-Signature Agreement" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third-party verification is necessary to validate your E-Signature, and that the lack of such certification or third-party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and Burlington County Bridge Commission. You are also confirming that you are the party authorized to enter into this Agreement. You further agree that each use of your email equates to your E-Signature and constitutes your agreement to be bound by the terms and conditions of these Disclosures and Agreement as they exist on the date of your E-Signature on this form.

Consent to Electronic Delivery

By selecting the “I Accept” button, you specifically agree to receive, obtain, and/or submit any and all Burlington County Bridge Commission documents and information electronically. These documents and information will be collectively known as "Electronic Communications," and will include, but not be limited to, any and all current and future required notices and/or disclosures. You accept Electronic Communications provided via email as reasonable and proper notice for the purpose of fulfilling any and all rules and regulations, and agree that such Electronic Communications fully satisfy any requirement that communications be provided to you in writing or in a form that you may keep.

Definitions

Electronic means technology having electrical, digital, magnetic, wireless, optical, electromagnetic, or similar capabilities.

Electronic Signature means an electronic symbol or process attached to, or logically associated with, a record and used by a person with the intent to sign the record.

Paper version of Electronic Communications

You acknowledge and agree that you may request a paper version of the employment application or other documents by printing or saving a copy from Burlington County Bridge Commission website.

Revocation of electronic delivery

You have the right to withdraw your consent to submit communications at any time. You acknowledge that you are aware this action may delay the process of reviewing your file. If you wish to withdraw your consent, you will contact the Burlington County Bridge Commission.

Violations

It is a violation of this provision for an individual to sign/e-sign a transaction on behalf of another individual, unless he or she has been granted specific, written and legal authority to do so by that individual or by a court of competent jurisdiction.

By typing your name below and clicking on “E-Signature Agreement” above, the signer recognizes and agrees to each and all of the Terms and Conditions in this Burlington County Bridge Commission employment application Consent for Use of Electronic Signature Agreement. My electronic signature is legally binding.
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