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Bureau of Human Resources

sfedor@harrisburgpa.gov

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

717-255-3040

Full Time Employment Application

1. Type of Work Desired

2. Personal Information

3. Military Status

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.

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.




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.

Draw Type
SEQ CHAPTER HR1 AFFIDAVIT I certify that the information provided in this application for employment is true and complete to the best of my knowledge. I authorize the City of Harrisburg to make an investigation of any of the information set forth in this application and release the City of Harrisburg and its agents from any liability. I agree and consent to this application being rejected without cause or hearing if any of the information herein contains any misrepresentation or falsification or if any material information has been omitted. I fully recognize that if I submit an incomplete application, such application will not be accepted by the Bureau of Human Resources. I fully recognize that if I provide information not required on the application, the application will not be accepted by the Bureau of Human Resources. I understand if any of the information herein contains any misrepresentation or falsification or if any material information has been omitted, I will be disqualified from consideration and will not be permitted to make future application for any position with the City of Harrisburg for a period of three (3) years from the date of notification of disqualification. I further understand if I am hired by the City of Harrisburg and if any misrepresentation, falsification or omission of material information in this application for employment is determined after my date of hire, I will be considered to have voluntarily terminated my employment and will not be permitted to make future application for any position with the City of Harrisburg for a period of three (3) years from the date of notification of termination. NOTICE TO APPLICANT If you are considered for possible employment with the City of Harrisburg, you will be required to undergo a background investigation to verify your suitability for the position for which you are being considered. In order for a background investigation to be performed, you must authorize the City of Harrisburg and/or its agent to perform such. The background investigation may include verification of employment, military service, education, criminal history, credit history and driving record.
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You will be provided with a Receipt upon submission.