Application for Employment

Application for Employment

  Application for Employment               P.O. Box 639

          Abilene USD 435                          Abilene, KS 67410

Position(s) Applied For: Please check all that apply                Date of Application 

Sectretarial  Instructioncal Assistant  Classroom Aide  Paraprofessional  Food Service  Bus Driver

Custodial/Maintenance  Other 

Name     

Address  

Telephone            Social Security Number  

E-mail Address  

If you are under 18, can you furnish a work permit?   Yes   No

Have you ever been employed here before?   Yes  No

Are you legally eligible for employment in this country?   Yes  No

     (Proof of U.S. citizenship or immigration status will be required upon employment.)

Date available for work 

Type of employment desired   Full Time   Part-Time   Temporary   Seasonal   Educational Co-Op

Are you able to meet the attendance requirements of the position?   Yes   No

Have you ever been convicted of a crime other than a minor traffic offense?  Yes   No

      (Such convictions may be relevant if job related, but does not bar from employment.)

If yes, please explain:  

Driver's license number (if required by job)    State 

There will be a drug screening and background check prior to offer of employment.

 

EMPLOYMENT HISTORY

List your last four (4) employers, assignments or volunteer activities, starting with the most recent, including military service.                                                                                      

Job Title:    Employer:   Telephone: 

From:   To:   Address: 

Immediate Supervisor and Title: 

Summarize the nature of work performed and job responsibilities: 

Reason for Leaving:   Hourly Rate/Salary: 

 

Job Title:    Employer:   Telephone: 

From:   To:   Address: 

Immediate Supervisor and Title: 

Summarize the nature of work performed and job responsibilities: 

Reason for Leaving:   Hourly Rate/Salary: 

 
 

Job Title:    Employer:   Telephone: 

From:   To:   Address: 

Immediate Supervisor and Title: 

Summarize the nature of work performed and job responsibilities: 

Reason for Leaving:   Hourly Rate/Salary: 

 
 

Job Title:    Employer:   Telephone: 

From:   To:   Address: 

Immediate Supervisor and Title: 

Summarize the nature of work performed and job responsibilities: 

Reason for Leaving:   Hourly Rate/Salary: 

 

Summarize special skills and qualifications acquires from employmnt or other experiences that may qualify you for work with our company: 

 

EDUCATIONAL BACKGROUND

|     Name and Location       |  Years Completed   |   Did you graduate?   |    Course of study    |

               Yes    No          

               

                 

_________________________________________________________________________________________________

REFERENCES

Name:    Telephone:   Job Related/Personal: 

Name:    Telephone:    Job Related/Personal: 

Name:     Telephone:    Job Related/Personal: 
_________________________________________________________________________________________________
 
APPLICANT JOB APPLICATION ACKNOWLEDGEMENTS

I certify that all the information provided by me in this application IS true and complete. I understand that any misstatement, falsification, or omission of information is grounds for refusal to hire, or if I am hired and the same is discovered thereafter, termination.

authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability for any damages that may result from furnishing such information to you. I authorize any background checks by any third party.

I authorize you to request, receive, and verify all information given on this application and I release you from all damages that may result from your doing so.

I authorize you to conduct a criminal background investigation using any and all methods necessary to successfully complete such investigation and I release you from all liability for any damages that may result from your doing so.

The Employer is an Equal Opportunity Employer. The Employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state, or federal law.

This application is current for only 60 days. At the conclusion of this time, if I have not heard from the Employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that just as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary.

I understand that if I am offered provisional employment in the school district that my fingerprints may be taken and a request made for a state and national criminal background check. I further understand that if the results of this criminal history check reveal that I have been convicted of any offense or any attempt to commit any offense specified in K.SA. 1999 Supp. 72-1397 and amendments thereto that my employment may be terminated. 

Signature of Applicant:     Date:

I am also interested in employment with an Educational Coop or Headstart program.  Yes   No



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