GENERAL EMPLOYMENT APPLICATION

Address *

Line 1

Line 2

City

State

Zip Code

Country

Are you age 18 or over?

Choose One *

YES NO

DATE OF BIRTH *

1. POSITION APPLYING FOR *

2. POSITION APPLYING FOR *

EDUCATION AND TRAINING

EDUCATION COMPLETED:

NAME OF LAST HIGH SCHOOL ATTENDED *

Address *

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City

State

Zip Code

Country

Graduated?

GED CERTIFICATE

Choose One *

YES NO

ISSUED BY *

Untitled *

NAME OF COLLEGE /UNIV *

MAJOR *

MINOR *

TYPE OF DEGREE *

Address *

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Line 2

City

State

Zip Code

Country

If you plan to earn a degree within the next few months, give time you expect degree:

OTHER SCHOOLS OF TRAINING (Trade, Vocational, Armed Forces, or Business) GIVE NAME AND LOCATION OF EACH SCHOOL., SUBJECTS STUDIED, CERTIFICATES, AND ANY OTHER PERTINENT DATA.

SPECIAL QUALIFICATIONS AND SKILLS (Licenses, skills with machines, computer skills, patents or inventions, publications, public speaking, professional or scientific societies, typing or shorthand speed, honors, awards and fellowships, foreign languages, etc..

VETERAN
Do you have Military Service?

IF JOB REQUIRES. DO YOU HAVE A VALID DRIVER'S LICENSE?

IF SUPERVISOR (NUMBER OF EMPLOYEES YOU SUPERVISED) *

PREVIOUS EMPLOYER(2)

PREVIOUS EMPLOYER (3)

References
List three persons who are not related to you and who have definite knowledge of your business or professional qualifications for the position for which you are applying. Do not repeat names of supervisors listed under work history. Labor and Workforce Development does not verify references, but employers utilizing this application may.

FULL NAME & PHONE NUMBER *

FULL NAME &PHONE NUMBER *

BUSINESS /HOME ADDRESS *

BUSINESS /HOME ADRESS *

BUSINESS/OCCUPATION *

BUSINESS /OCCUPATION *

ARE YOU ELIGIBLE TO WORK IN THE UNITED STATES?

HAVE YOU BEEN CONVICTED OF A FELONY WITHIN THE LAST 7(SEVEN) YEARS?

CERTIFICATION
I CERTIFY THAT ALL OF THE STATEMENTS MADE IN THIS APPLICATION ARE TRUE, COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF, AND ARE MADE IN GOOD FAITH.

GENERAL APPLICATION
non-certified

PERRY COUNTY BOARD OF EDUCATION