Employment Desired

    Position Applying For *

    Type of Work *

    If applying for temporary/seasonal work

    Days available to work

    During what period of time will you be available?

    Available for work on weekends?

    Are you younger than 18 years of age?

    Personal Information

    First Name *

    Middle Initial

    Last Name *

    Mailing Address

    Address *

    City *

    State *

    Zip *

    Physical Address

    Address

    City

    State

    Zip

    Email address *

    Phone Number *

    Employment History

    Failure to complete this section may result in disqualification. A resume is not a substitute for completing the Employment History section. Substantial gaps in employment should be explained. List all jobs you have held in the past 10 years. PUT YOUR PRESENT OR MOST RECENT JOB FIRST. Include military service. By being thorough you may improve your chances for employment. If you need more space you may attach additional sheets. You must include number of hours worked each week.

    Job 1

    From

    To

    Total Years

    Full Time or Part Time?

    Employer's Name

    Job Title and Duties

    Employer's Address

    Supervisor

    Phone Number

    Reason for Leaving

    May we contact this employer for a reference?

    Job 2

    From

    To

    Total Years

    Full Time or Part Time?

    Employer's Name

    Job Title and Duties

    Employer's Address

    Supervisor

    Phone Number

    Reason for Leaving

    May we contact this employer for a reference?

    Job 3

    From

    To

    Total Years

    Full Time or Part Time?

    Employer's Name

    Job Title and Duties

    Employer's Address

    Supervisor

    Phone Number

    Reason for Leaving

    May we contact this employer for a reference?

    Job 4

    From

    To

    Total Years

    Full Time or Part Time?

    Employer's Name

    Job Title and Duties

    Employer's Address

    Supervisor

    Phone Number

    Reason for Leaving

    May we contact this employer for a reference?

    Education

    Do you have a high school diploma or G.E.D?

    Name of High School

    Do you have an AA/AS degree?

    Do you have a BA/BS degree?

    Do you have a post graduate degree?

    College/University/Trade School

    NOT high school

    Name of institution

    Course or major

    Hours of units completed

    Did you graduate?

    Degree received

    College/University/Trade School

    NOT high school

    Name of institution

    Course or major

    Hours of units completed

    Did you graduate?

    Degree received

    College/University/Trade School

    NOT high school

    Name of institution

    Course or major

    Hours of units completed

    Did you graduate?

    Degree received

    College/University/Trade School

    NOT high school

    Name of institution

    Course or major

    Hours of units completed

    Did you graduate?

    Degree received

    Licenses and Certifications

    List Licenses or Professional Certifications/Registrations Relevant to This Position:

    Details

    Type

    State

    Class

    Number

    Expiration Date

    Details

    Type

    State

    Class

    Number

    Expiration Date

    Details

    Type

    State

    Class

    Number

    Expiration Date

    Has your license/certification ever been revoked or suspended?

    If yes, state reason(s), date of revocation or suspension, and date of reinstatement.

    Do you have a valid driver's license?

    A current DMV report showing an acceptable driving record will be required after job offer and prior to employment.

    Other Personal Information

    Do you have any relatives working for the District?

    If yes, please identify:
    Name

    Relationship

    Department

    If hired, can you present evidence of your U.S.citizenship or proof of your legal right to live and work in this country?

    Have you been given a copy of the Job Description which outlines the essential functions of the job for which you are applying?

    Are you able to perform the essential functions of the job which you are applying, either with our without reasonable accommodation?

    If no, describe the functions that cannot be performed.

    If you become a finalist for the position, do you have any objection to a representative of the District making inquiry of your present employer regarding your background and qualifications?

    If yes, state the reason

    If now employed, why do you want to leave?

    Please provide in this space: 1) Any additional information you would like to have the District consider, 2) Any substantial gap in your employment history, and further explanation to any "yes" response

    How did you hear about this job?

    Please specify

    I HEREBY CERTIFY that the foregoing statements are true and accurate to the best of my knowledge and belief. I agree and understand that any misstatement of material fact contained in this application may cause me to forfeit all rights to employment with the District. Employment offer may be contingent on passing a job-related physical examination, drug test, and fingerprint background check.