Application for Employment

The Opportunity to Compete Act, N.J.S.A. 34:6B-11 to 19, went into effect on March 1, 2015. Under this new law, an employer cannot make any inquiry—either verbally or in writing, including in an employment application—about an applicant's criminal record during the Initial Employment Application Process, unless one of the limited exceptions below applies.

The Initial Employment Application Process refers to "the period beginning when an applicant for employment first makes an inquiry to an employer about a prospective employment position or job vacancy or when an employer first makes any inquiry to an applicant for employment about a prospective employment position or job vacancy, and ending when an employer has conducted a first interview, whether in person or by any other means, of an applicant for employment." Employers can make this inquiry after the Initial Employment Application Process has concluded (i.e., post-interview).
The Act allows employers to request criminal history information before the first interview in the following limited circumstances:

• If an applicant voluntarily discloses his or her criminal history during the Initial Employment Application Process.

• Where the applicant is seeking a position in law enforcement, corrections, the judiciary, homeland security or emergency management.

• Where the applicant is seeking a position where a criminal history record background check is required by law, rule or regulation.

• Where the applicant may be legally precluded from holding the position by virtue of his or her arrest or conviction.

• Where any law, rule or regulation restricts an employer's ability to engage in specified business activities based on the criminal records of its employees.

• Where the applicant is seeking a position designated by the employer as part of a program designed predominately to encourage the employment of persons who have a criminal record.

Job applicants are considered for all positions without regard to race, creed, color, national origin, sex, affectional or sexual orientation, age, religion, marital, or veterans’ status, or disability. The State will not tolerate any form of discrimination or sexual harassment.
The Americans with Disabilities Act of 1990 as amended prohibits employers from discriminating against any qualified person on the basis of a disability. The State of New Jersey makes reasonable accommodations during all aspects of the employment process, such as testing and interviews. The State also makes reasonable accommodations in the work environment to enable a person with a disability to perform the essential job functions and to participate equally with co-workers without disabilities. However, the State can only make reasonable accommodations when it is aware of a disability. It is up to you to inform the prospective employer if you need a reasonable accommodation. The employer may ask you for documentation to support your request for a reasonable accommodation.

Feel free to add any information which will help to place you. Please be aware that misrepresentation may be cause for removal. Proof of Age, Education, and Citizenship will be required prior to employment offer.

Name

First

Middle

Last

Your Phone Number

Your Email

Address

Address Line 1

Address Line 2

City

State

Zip Code

Position Applying For:

Indicate preferred work schedule (Mark all that apply)

If you chose days per week above, how many days?

If you chose numbers of nights per week above, how many nights?

Are you 21 years old or older?

Yes
No

Do you possess a drivers license that is valid in New Jersey?

Yes
No

Are you either a U.S. citizen or an alien authorized to work in the U.S.?

Yes
No

Have you ever been convicted of a crime or other offense which has not been expunged by the Court, either in New Jersey or in any other jurisdiction? (A conviction will not necessarily preclude you from employment.)

Yes
No

If Yes, give details below:

Have you ever worked or been educated under a different name?

Yes
No

If yes, specify here:

EDUCATION/SKILL HISTORY

Please list all vocational, technical, correspondence schools, colleges and universities you have attended. Upon employment be prepared to provide supporting documentation of schools attended.

High School Last Attended:

Diploma/Degree Received:

Years Attended:

College or University:

College Diploma/Degree Received:

College Years Attended:

Graduate School:

Graduate Diploma/Degree Received:

Graduate School Years Attended:

Other Formal Training (include Certificate Programs):

Do you speak any other language besides English? Please list all.

Employment History

List all employment starting with present or last position.

Employer's Name and Complete Address:

Layout

From:

May we contact the supervisor?

Yes
No

To:

Telephone Number

Position Title:

Worked:

Part Time
Full Time

Supervisors Name:

Reason for leaving:

Description of Duties:

Employer 2

Employer's Name and Complete Address:

Layout

From:

May we contact the supervisor?

Yes
No

To:

Telephone Number

Position Title:

Worked:

Part Time
Full Time

Supervisors Name:

Reason for leaving:

Description of Duties:

GENERAL INFORMATION

Please add any additional information which will help in placing you where you are best qualified. Include such items as: honors, hobbies, publications, volunteer work, public speaking and writing experience, membership in professional or scientific societies.

List three people unrelated to you whom we may contact for information concerning your qualifications.

Layout

Name Reference 1

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Occupation:

Name Reference 2

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Occupation:

Name Reference 3

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Occupation:

Please indicate a telephone number where and at what time you may be contacted for an interview:

Authorization

I authorize my former employers to release any information they may have concerning my employment record and I release Timber 5 LLC and all previous employers listed above from all liability whatsoever that may issue from securing this information. I further authorize representatives of this agency to verify any and all information contained in this application, including education, and to review any and all criminal history, military and disciplinary records of any source. By signing below, I understand that I will be required to submit fingerprints that will be sent to the local, County and State police as part of a background check as required by NJ State Cannabis Regulatory Commission. I CERTIFY that the information on this application is complete and accurate, to the best of my knowledge. I understand that any misleading or incorrect information may render this application void and be just cause for immediate termination if employed.
I do not agree and my application will not be processed at this time.

Job Application

Application for Employment

Feel free to add any information which will help to place you. Please be aware that misrepresentation may be cause for removal. Proof of Age, Education, and Citizenship will be required prior to employment offer.

EDUCATION/SKILL HISTORY

Employment History

Employer 2

GENERAL INFORMATION

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