Strafford County Department of Corrections
266 County Farm Road
Dover, NH 03820-6003
(603) 742-3310 
Application for Employment



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OF THE JOB FOR WHICH YOU ARE APPLYING.

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Applicant’s Statement

I certify that answers given herein are true and complete.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. l hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an ''at will" nature. which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically. acknowledged in. writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I
understand, also, that I am required to abide by all rules and regulations of the employers.

AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION

County Seal 1

STRAFFORD COUNTY DEPARTMENT
OF CORRECTIONS
266 County Farm Road
Dover, New Hampshire 03820
Telephone: (603) 742-3310
Fax: (603) 742-2192

I, do hereby authorize the Strafford County Department of Corrections to conduct a pre-employment personal history investigation. I further authorize the release of information contained in records,
reports and statements. In addition, I authorize the Strafford County Department of Corrections to conduct such character
reference interviews as may be deemed necessary by the department for the position for which I have applied.
Authorization is specifically granted to investigate and obtain records and information concerning the following:
1. Previous employment history.
2. Records of any criminal convictions that have not been annulled.
3. Motor vehicle driver history in this or any other state.
4. Record of any issued protective orders relative to domestic violence.
5. Any other data or information which has a direct bearing on the suitability for employment.
I hereby release said person( s), agencies or businesses that furnished or obtained such personal history information from
any and all liability which may have been incurred as the result of this personal history investigation. A photocopy of this
information release authorization will constitute as a valid document.

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