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Bureau of Human Resources

sfedor@harrisburgpa.gov

10 N. 2nd Street, Suite 406 Harrisburg, PA 17101

717-255-3040

Form Section 1

Full Time Employment Application

1. Type of Work Desired

2. Personal Information

3. Military Status

Form Section 2

4. Education

5. General Information

6. Licenses, Certificates, Special Qualifications and/or Skills

7. Foreign Language

Indicate any foreign language skills you have and rate your level of knowledge for each. If you have no foreign language skills skip this section.

Form Section 3

8. Employment History

Beginning with your most recent job, list your entire work history for the past ten (10) years, including full-time, part-time, temporary and seasonal employment AND all periods of unemployment. List full addresses and zip codes.




Form Section 4

9. Vehicle Operator's License

List the following information for ALL vehicle operator’s licenses you now hold or have held in the last 3 years from the date of application.


You will be provided with a Receipt upon submission.