USD #421 Lyndon

Please Fill Out The Job Listings and Application Below

Personal Data

Date:

Name

Address

City

State

Zip

Home Phone Number

Cell Phone Number

Email:

Employment Desired

Position Applied For

Reaquired field: Full Time Cook

Reaquired field: Bus Driver

General Information

If you are under the age of 18, can you provide required proof of your eligibility to work?

Reaquired field: Yes

Reaquired field: No

Have you filed an application with the district before?

Reaquired field: Yes

Reaquired field: No

Have you been employed by the district before?

Reaquired field: Yes

Reaquired field: No

If yes, provide dates of employment.

Are you currently employed?

Reaquired field: Yes

Reaquired field: No

May we contact your present employer?

Reaquired field: Yes

Reaquired field: No

On what date will you be available for work in our district?

Are you available to work:

Reaquired field: Full Time

Reaquired field: Part Time

Reaquired field: Temporary

Are you currently on "lay-off" status and subject to recall>

Reaquired field: Yes

Reaquired field: No

References

References: List the name of four references capable of giving information about your character and work experience. List at least one supervisor you worked under as an employee.

Full Name of Reference #1

Position

Reaquired field: Reference's Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Phone

Full Name of Reference #2

Position

Reference's Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Phone

Full Name of Reference #3

Position

Reaquired field: Reference's Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Phone

Full Name of Reference #4

Position

Reaquired field: Reference's Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Phone

Education

High School Attended

Reaquired field:

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Year Graduated:

Educational and Professional Training

Date Attended From:

Date Attended To

Name of School

Address of School:

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Degree or Certifications Earned

Work Experience (List most recent position first)

Job Title

From:

To:

Work performed:

Name of Supervisor:

Final Salary or Hourly Wage Amount:

Reason for Leaving:

Job Title:

From:

To:

Worked Performed:

Name of Supervisor

Final Salary or Hourly Wage Amount:

Reason for Leaving:

Job Title:

From:

To:

Worked Performed:

Name of Supervisor

Last Salary or Hourly Wage:

Reason for Leaving:

Job Title

From:

To:

Worked Performed:

Name of Supervisor

Last Salary or Hourly Wage:

Reason for Leaving:

Job Title:

From:

To:

Worked Performed:

Name of Supervisor

Final Salary or Hourly Wage:

Reason for Leaving:

Disclosures

Are you willing to accept any assignment for the good of the school system, attend meetings or participate in other activities outside of school hours or Saturday mornings?

Reaquired field: Yes

Reaquired field: No

Have you ever failed to be rehired, been asked to resign a position, resigned to avoid termination, or terminated from employment?

Reaquired field: Yes

Reaquired field: No

If Yes, explain:

Why do you wish to leave your present position?

On what date will you be available if offered employment at School Name?

Are you a relative of any board member, administrator, or supervisor who is currently serving the district?

Reaquired field: Yes

Reaquired field: No

If Yes, please provide the name of the board member, administrator, or supervisor.

Can you perform all of the essential job function(s) of the position(s) for which you are applying, with or without reasonable accommodation?

Reaquired field: Yes

Reaquired field: No

List any accommodations:

Legal Information (Please note applicants are not obligated to disclose sealed or expunged records.)

Have you ever been convicted of a criminal offense other than a minor traffic violation?

Reaquired field: Yes

Reaquired field: No

If Yes, explain and giving dates:

Have you ever had any indicated finding of child abuse filed in your name:?

Yes

If Yes, explain and giving dates:

Does your name appear on any Sex Offender Database in any state or country?

Reaquired field: Yes

Reaquired field: No

Applicant's Acknowledgment and Agreement

Email a copy to

optional

Required Fields

Job Listings and Application

USD #421 CLASSIFIED STAFF VACANCIES APPLICATION FOR NON-CERTIFIED STAFF POSITION

USD #421 CLASSIFIED STAFF VACANCIES
APPLICATION FOR NON-CERTIFIED STAFF POSITION