Employment Application Form

Full Name *

First Name Middle Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone

- Area Code Phone Number

Work Phone

- Area Code Phone Number

E-mail

Do you have the right to work in the U.S.? (Proof required if hired)

Yes No

What Position are you applying for?

On what date would you be available to begin work?

- Month - Day Year

Have you been employed by the library before?

Yes No

If so, date worked?

Will you accept full time/part time work?

Please list the names and relationships of any relatives currently employed by the Ouachita Parish Public Library.

Name; relationship

I understand that by applying for this job I will be required to work some evenings, Saturdays, and/or Sundays.

Yes

Name of High School

Name of High School Attended

Highest Grade Completed?

Graduated?

Yes

Year?

Name of College

Name of College/University Attended

Highest Grade Completed?

Graduated?

Yes

Year?

Area of Study/Degree

Additional School

Name of Graduate School Attended

Highest Grade Completed

Graduated?

Yes

Year?

Area of Study/Degree

Are you a current/former member of the Military

Yes No

Date Enlisted

Date Discharged

Skills

List any relevant skills

Qualifications

List any relevant certifications or qualifications

List any equipment or machines you can operate:

List your computer experience or any computer courses you have completed:

Special skills, as story telling, public speaking, media experience, art, awards, training, professional courses:

Previous Employer

Name of Current Employer or NONE if not Employed

Address

City

State/Zip

Contact Name

Phone

May We Contact?

Yes No

Dates Employed

Duties

Reason for leaving

Previous Employer

Name of Previous Employer

Address

City

State/Zip

Phone

Contact Name

May We Contact?

Yes No

Dates Employed

Duties

Reason for leaving

Name of Reference

Title

Company Name

Address

City

State/Zip

Phone

Email

Name of Reference

Title

Company Name

Address

City

State/Zip

Phone

Email

Additional Information

Cover Letter

Resume

"I hereby warrant that the information given by me on and with this form is true, correct, and complete, and I understand that if I am employed by the Ouachita Parish Public Library and it is found, at any time during my employment, that any of such information is false, I will be subject to dismissal. I furthermore agree, if employed to follow all rules and regulations of the library. I hereby authorize my former employers or references, whose names I will give, to furnish any information concering my personal character, habits, ability, disposition, and other qualifications, and I release them from any and all liabilities or damages of whatsoever nature on account of furnishing such information."

"If offered employment at the Ouachita Parish Public Library, I agree to be tested and to successfully pass a drug screening in order to be added to the payroll. The screening will be done by an independent laboratory with the cost to be covered by the Ouachita Parish Public Library. I agree and give my permission for the Ouachita Parish Public Library to conduct a background check."

I agree to the above statement by providing my name in the box below:

Date:

A digital signature is recommended to fill this form out and submit it via email.

Signature

Clear

Ouachita Parish Public Library is an Equal Opportunity Employer and an At Will Employer.

Employment Application Form:

Personal Information:

Employment Desired:

Education:

Skills/Qualifications:

Previous Employment:

Personal and Business References:

Cover Letter & Resume (Optional):

Your signature to the following statement is necessary to secure consideration of your application.