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205 Rocky Hill Rd. Northampton MA 01060 | (413) 584-5911

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Visitation
Treatment/Programming
Civil Process Division
Community Justice Support Center
- About
- Services & Support
Triad
- About
- Triad Programs
Additional Programs
- Rocky Hill Re-Entry Program
- Bridge to the Future
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Instructions

Please read the Confidential Employment Application carefully and answer EVERY question in full. If you cannot answer or do not understand any part of this application, notify a member of the Hampshire Sheriff’s Office Human Resources immediately. If you need additional space to complete an answer, please attach additional sheets containing the information to this application. In addition to the information required below, please provide any other information you think would be helpful to us in considering you for employment. You may exclude all information indicative of age, sex, race, religion, color, national origin, and disability.

General Information:

Mandatory field First Name:*

Middle Initial:

Mandatory field Last Name:*

Have you ever used or been known by another name?

Mandatory field Address:*

Mandatory field City / Town:*

Mandatory field State:*

Mandatory field Zip:*

Mandatory field Mailing Address:*

Mandatory field Telephone:*

Mandatory field Email Address:*

Mandatory field Are you a United States citizen or authorized to work in the United States?* Yes No

Mandatory field Are you at least 19 years of age?* Yes No

Mandatory field Have you ever been employed here before?* Yes No

If yes, please provide dates:

Mandatory field Are you available to work:* Full-time Part-time Temporary Contractual

Mandatory field Position Applying For:*

Mandatory field Minimum salary requirement:*

Mandatory field Date available to begin work:*

How were you referred to us?

Newspaper Ad:

Online Job Posting:

Name and Address

Years Completed

Graduated Yes No

Course or Major

Degree / Major

Describe any certificate, license, skills, or rating you may hold:

Honors received:

List any languages, other than English, that you speak, read, write, etc:

State any additional information you feel may be helpful to use in considering your application:

Military Experience:

Mandatory field Have you ever served in the U.S. armed forces?* Yes No

If yes, what branch?

Dates of duty:

From

Rank at discharge:

Under what conditions were you discharged? Honorable Dishonorable

What were your duties in the service?

Are you a U.S. Veteran? Yes No

Have any of the following occurrences happened to you in the last ten (10) years?

Fired from job Yes No

Date

Employer Name & Address

Detailed explanation:

Quit a job after being told you would be fired. Yes No

Date

Employer Name & Address

Detailed explanation:

Mandatory field Are you presently on lay off and subject to recall?* Yes No

Should you be offered employment, would you consent to a medical examination, as a condition of employment, conducted solely for the purpose of determining whether you are, with reasonable accommodation, capable of performing the essential functions of the job?*

Yes No

Person to be notified in case of emergency

Mandatory field Name:*

Mandatory field Address:*

Mandatory field Telephone:*

Upload Resume:

You will be required to produce documentation to establish your identity and your authorization to work in the United States in accordance with the immigration reform and control act of 1986.

By submitting this application, you agree to a background check.

Contact Us

205 Rocky Hill Road
Northampton, MA 01060
(413) 584-5911

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Inmate/Visiting Info

Visiting Hours
Visiting Approval
Length and Number of Visits
Entrance Procedures
Conduct
Visitor Dress Code
Property/Money Dropoff
Termination of Visits

Departments

Treatment/Programming
Civil Process Division
Community Justice Support Center
TRIAD
Rocky Hill Re-Entry Program
Bridge to the Future

For Inmate telephone issues, or if you are an attorney looking to add your phone number to the Privileged Telephone Correspondence please contact ICS (Inmate Calling Solutions) at 1-888-506-8407or by email at Andrew.Burns@Praeses.com.