Form Center

I. Contact Information

An Equal Opportunity Employer
The Town of Upton is an equal opportunity employer and does not discriminate against any applicant because of race, color, religion, sex, marital status, national origin, age, disability, sexual orientation or any other class protected by federal, state or local law. Any person who needs assistance in fully participating in the application process should contact the Town of Upton Human Resources Department.
Full Legal Name*
Preferred Name
Address*
City*
State*
Zip Code*
Email Address*
Phone Number*
Date*
Date
Will you be 18 years of age or older at the start of this position?*
1. Yes
2. No
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II. Position Applying For

III. Educational Achievements

Select all levels of schooling you have completed or are currently attending.*
1. Middle School
2. High School
3. College/University
4. Graduate School
5. Trade/Business Courses
6. Military Service or Other Training
Middle School Name*
Number of Years Attended*
Degree/Certificate Granted*
High School Name*
Number of Years Attended*
Degree/Certificate Granted*
College/University Name*
Number of Years Attended*
Degree/Certificate Granted*
Graduate School Name*
Number of Years Attended*
Degree/Certificate Granted*
Trade/Business Courses Name*
Number of Years Attended*
Degree/Certificate Granted*
Military Services or Other Training Name*
Number of Years Attended*
Degree/Certificate/Rank Granted*
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IV. Licenses

Please list all current licenses you possess that are relevant to the position you seek. A current valid license is a condition of employment where required.*
1. Do you have a valid driver’s license (Class D auto)?
2. Do you have a valid CDL license (Class A or B?)?
3. Do you have a valid Hydraulic license?
4. Any other valid licenses or certificates do you hold? (Job Related)
5. None
Drivers License Expiration Date*
CDL License Expiration Date*
Hydraulic License Expiration Date*
Other licenses/certificates*
Other licenses/certificates expiration dates*
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V. Office Skills

VI. Employment History

Please account for the last four positions you have held. Start with your present or last employer. You may include military service and any verifiable work performed as an intern or volunteer.
(Please do not write “see resume.”)
May we have permission to contact your present employer?*
1. Yes
2. No
1. Employer
Address
Supervisor
Dates Worked
Dates Worked Start Date
—
Dates Worked End Date
Reason For Leaving
Description Of Primary Duties
2. Employer
Address
Supervisor
Dates Worked
Dates Worked Start Date
—
Dates Worked End Date
Reason For Leaving
Description Of Primary Duties
3. Employer
Address
Supervisor
Dates Worked
Dates Worked Start Date
—
Dates Worked End Date
Reason For Leaving
Description Of Primary Duties
4. Employer
Address
Supervisor
Dates Worked
Dates Worked Start Date
—
Dates Worked End Date
Reason For Leaving
Description Of Primary Duties
Have you ever been forced to resign from any position?*
1. Yes
2. No
Please Provide Details*
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VI. References

A minimum of three references are required.
Please do not write “see resume.”
1. Name*
Address*
Phone #*
Relationship*
2. Name*
Address*
Phone #*
Relationship*
3. Name*
Address*
Phone #*
Relationship*
4. Name
Address
Phone #
Relationship
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VII. Policies

Employment Of Minors: The Town of Upton is subject to certain child labor provisions regarding the employment of persons under the age of 18. Further, an employment Permit or Educational Certificate may be required, depending on the age of the minor. Are you under the age of 18?*
1. Yes
2. No
Medical Information: All offers of employment are conditional upon a physical examination, and an occupational evaluation, where required. Satisfactory ability to perform the essential functions of the position is a condition of employment.*
Write your initials to acknowledge.
Pre‐Employment Drug Testing: All offers of employment are conditional upon the satisfactory completion of a pre-employment drug test, where required. Satisfactory completion of a required drug or alcohol test is a condition of employment as outlined in the Drug and Alcohol Testing Policy of the Town of Upton.*
Write your initials to acknowledge.
Lie Detector Test: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.*
Write your initials to acknowledge.
CAREFULLY READ ALL PARTS OF THIS APPLICATION FORM BEFORE SIGNING.
A. I understand that acceptance of this application by the Town of Upton does not imply that I will be employed. (Exception to A Is an employee filling out this application for promotional purposes only.)
B. The information that I have provided is true and complete. I understand that misrepresentation or omission of any fact in my application, resume, or in any other materials, or as provided during interviews, can be justification for refusal of employment or can be justification for termination from employment, if employed.
C. I understand that any offer of employment that I receive from the Town of Upton is contingent upon my successful completion of the pre-employment screening process, including but not limited to the Town of Upton receiving satisfactory references, a satisfactory criminal history and Criminal Offense Record Inquiry if required, satisfactory verification of driver’s license or certifications where required, satisfactory completion of any required post-offer pre-employment drug test or physical examination.
D. In processing my application of employment, the Town of Upton may verify all the information provided by me concerning, among other things, my prior employment or military record, education, character, general reputation and personal characteristics. I hereby agree to release the town from any and all liability arising out of the verification process.
E. I authorize the Town to take whatever steps deemed necessary to obtain information regarding my qualifications for employment including contacting my present and former employers, by contacting individuals listed as business, educational or personal references, and by contacting other individuals to provide or further clarify information about me.
F. I hereby release my present and former employers and all individuals contacted for factual information about me from any and all liability damages arising from furnishing the requested information.
G. If employed by the Town of Upton, I understand that as a condition of employment, I may be required to furnish additional or updated medical information, that I may be required to undergo a physical examination, and/or an occupational evaluation, that I may be subject to drug and/or alcohol testing, that the Town may request a Criminal Offense Record Inquiry (CORI check) on me, investigate my driving record or verify my license(s) or certification(s) as required for employment at any time during my employment. As a condition of employment an employee may be required to provide additional or updated information especially if this employee has been on workers comp and may require both drug testing and an employment physical in order to allow us to have the necessary information for making a proper decision or reasonable accommodations, if necessary.
H. I understand that the Town of Upton is an at-will employer. If employed, I understand that my employment may be terminated with or without cause at any time unless there is an appropriate bargaining unit contract. My signature certifies that I have read and agree with the above statement and all statements contained in this Application for Employment.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature*
Date*
Date
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Scheduling Your Interview

Create your interview username: In the box below write "N", dash and your initials
Example: N-MDC
N = New Hire
MDC = My initials
*This is the username you will use to sign up for your interviews*
Create your interview username: In the box below write "R", dash and your initials
Example: R-MDC
R = Returner
MDC = My initials
*This is the username you will use to sign up for your interviews*
New Hire Interview Link
New Hire Interview Schedule
Use the username you created above to sign up for your interview timeslot.
Same this link incase you need to change your interview date or time.
Returner Interview Link
Returner Interview Schedule
Use the username you created above to sign up for your interview timeslot.
Same this link incase you need to change your interview date or time.

Leave This Blank:

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

This field is not part of the form submission.
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Town of Upton Employment Application 2026

Steps

I. Contact Information

II. Position Applying For

III. Educational Achievements

IV. Licenses

V. Office Skills

VI. Employment History

VI. References

VII. Policies

Scheduling Your Interview

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