Employment Application

First Name*

Last Name*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email Address*

Position Applying For*

What extracurricular activities have you supervised or would be interested in supervising?

High School: Name and Location of School*

Last Year Completed:*

Did you graduate?*

YesNo

College: Name and Location of School

Did you graduate?

YesNo

Subjects Studied and Degree(s) Received:

Trade, Business or Corresponding School: Name and Location of School

Did you graduate?

YesNo

Subjects Studied and Degree(s) Received:

Employer 1: (most current employer)*

Phone Number*

Please enter a valid phone number.

City/State:*

Supervisor:*

Job Title:*

Salary:*

Annual Salary or Hourly Rate

From:*

To:*

Specific Duties:*

Reason for Leaving:*

May we contact this Supervisor for a reference?*

YesNo

Employer 2: (2nd most current employer)

Phone Number

Please enter a valid phone number.

City/State:

Supervisor:

Job Title:

Salary:

Annual Salary or Hourly Rate

From:

To:

Specific Duties:

Reason for Leaving:

May we contact this Supervisor for a reference?

YesNo

Employer 3:

Phone Number

Please enter a valid phone number.

City/State:

Supervisor:

Job Title:

Salary:

Annual Salary or Hourly Rate

From:

To:

Specific Duties:

Reason for Leaving:

May we contact this Supervisor for a reference?

YesNo

Have you ever been terminated or asked to resign in your employment history?*

YesNo

If yes, please describe the reason for the dismissal.

First Name* Last Name* Area Code* Phone Number* Relationship* Years Acquainted*

VeteranDisabled Veteran

Signature

Cover Letter

Resume

Copy of License (if applicable)

Letter of Recommendation 1

Letter of Recommendation 2

Letter of Recommendation 3

Contingency, Certification, and Signature

I certify that the answers I have given on this application are true and correct to the best of my knowledge. I understand that any false or misleading information provided, or any omission or concealment of facts, will disqualify me from consideration for employment and may constitute grounds for my immediate dismissal should I be employed by the Esko Public Schools District No. 99. I hearby authorize investigation for all statements contained in this application and other application or employment credentials submitted. I also authorize any and all current and former employers, organizations where I have volunteered, references named in this application, or any agent of such a current or former employer or volunteer organization, to release to ISD 99 and its agents any and all public or private information regarding my job performances, fitness, or qualifications to perform this position I am presently seeking and any other employment or related information. I understand ISD 99 will use this information to determine my fitness and qualifications for the position I am seeking. I hearby release ISD 99 and all current and former employers, volunteer organizations, and references listed herein and any and all agents acting on behalf of ISD 99, former employers, volunteer organizations, or references from any and all liability of whatever nature by reason of requesting or providing such information.

I understand that Minnesote Statutes may require that I authorize and pay for a criminal background check should I be offered for this position.

I understand, acknowledge and agree that no offer of employment is valid or binding until formal approval by the ISD 99 School Board. Until such approval, ISD 99 shall not be liable for reliance on any oral or written offers of employment made to me. I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without and previous notice.

It is unlawful to knowingly hire an alien not authorized to work in the United States. Verification of all new hires will be by examining: 1) United States passport or 2) United States birth certificate or social security card and a driver's license, state issued ID card or alien identification document.

This authorization expires one year from the date of my signature below.

Date*

Date

Signature*

ISD 99 is an equal opportunity employer, dedicated to a policy of nondiscrimination in employment on any basis including race, creed, color, age, sex, sexual orientation, religion, or natural origin, marital status, or status with regard to public assistance of whatever nature or disability.

Esko Public Schools

Applicant Information

Education

Previous Employment

References:

Veteran's Preference