672 Main Street
Harleysville, PA 19438

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Employment Application

(You will not be denied employment soley because of a conviction record unless the offense is related tot the job for which you are applying. Nevertheless, a criminal history revealed of the criminal record check may be grounds for immediate dismissal if employment has begun.)


Employment Information


U.S. Military Service

Applicant's Statement

I certify that the facts contained in this application are true, correct, and complete. False, incomplete, or misrepresented information of any kind will be sufficient clause for my application to be rejected or, if discovered after I am employed, cause for immediate termination of my employment.

I understand that the employer follows an “employment at will” policy, in that the employer or I may terminate my employment at any time, or for any reason consistent with applicable state or federal law. I understand that this application is not a contract of employment. I understand that if hired my employment is for no definite period, regardless of the date of payment of my wages and salary, employment may be terminated at any time without prior notice.

I understand that this application will be active for a period of one year; after that time, if I wish to be considered for employment, I must submit a new application.

I understand that the employer will thoroughly investigate my work and personal history and verify all data given on the application, on related papers, and in interview. I authorize all individuals, schools, and firms named therein, except my current employer if so noted, to provide any information requested about me, and I release all parties from all liability for any damage in providing this information.