Town of Merrillville

Employment Application

Position(s) Applying For

Date

Last Name

First Name

Middle Name

Address

City

State

Zip Code

Home Phone Number

Mobile Phone Number

Email address

How did you learn about this job opportunity?

Indeed

www.merrillville.in.gov

Employee

Facebook

Other

Are you 18 years of age?

Yes

No

Are you a citizen of the United States?

Yes

No

Do you have a valid driver's license?

Yes

No

Have you ever been convicted of a felony?

Yes

No

Have you ever been employed with the Town of Merrillville?

Yes

No

Are you currently employed

Yes

No

What type of employment are you seeking?

Full-time

Part-time

Seasonal

On what date would you be available for work?

Upload Resume

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