secondary source of employment

Application for Secondary Source of Employment
Name
Department
I am requesting approval for a secondary source of employment:

YesNo
I currently have a secondary source of employment:

YesNo
I plan to pursue a secondary source of employment:

YesNo
If you answered yes to any of these questions, please fill out the following:
Company
Duties or Functions:
In obtaining approval for a secondary source of employment, I realize that my position with the Town is and must remain my primary source of employment. I also understand that my secondary source of employment must not interfere with the functions of the Town and shall not violate any policy of the Town.
Employee Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Application for Secondary Source of Employment