Online Employment Application

Application for Employment-Union County Public Library District

Completed applications need to be submitted online along with a resume.
Online Employment Application
Name

LastFirst
Middle Suffix
Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Last 4 numbers of Social Security #
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Email
example@example.com
Are you between the ages of 17-64 years of age?
Are you applying for a Co-Op position?
Are you legally authorized to work in the U.S.?
Have you previously been employed by the Union County Public Library District? If yes, give dates.
Give dates your were previously employed
Position you are applying for , salary expected .
If you have any relatives working for the Union County Public Library District, please list them : First Name Last Name Relationship .
First Name Last Name Relationship .

Employment History

(Please list last position first) (If none are available, leave blank)
Company Name #1

Dates of employment

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of immediate supervisor

First NameLast Name
Title of immediate supervisor
May we contact them?
Phone Number of immediate supervisor
Please enter a valid phone number.
Duties and responsibilities
rate of pay . Reason for leaving

Company Name #2

Dates of employment

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of immediate supervisor

First NameLast Name
Title of immediate supervisor
May we contact them?
Phone Number of immediate supervisor
Please enter a valid phone number.
Duties and responsibilities ,
rate of pay Reason for leaving
Professional References

(Please do not include relatives)
1.

First NameLast Name
Phone Number
Please enter a valid phone number.
How many years have you know this person?

Street Address Line 2

CityState / Province

Postal / Zip Code
2.

First NameLast Name
Phone Number
Please enter a valid phone number.
How many years have you known this person?

Street Address Line 2

CityState / Province

Postal / Zip Code
Please describe any positions or types of positions you should not be considered for, or job duties you cannot perform because of medical, and/or physical limitations.
To complete this application, email your resume to

ucnewcard@gmail.com or upload your resume below.
Resume

Cancelof
Signature of applicant

Clear
Signature: Parent or Guardian if applicant is under 18 Note: By signing this form, I (parent or legal guardian) agree to applicant submitting a drug test and/or background check.

Clear
Rate Us/Prepared by SM 10/31/20
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Application for Employment-Union County Public Library District