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Employment Application

Employment Application

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Published by odcpl
Application for employment at ODCPL
Application for employment at ODCPL

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Published by: odcpl on Feb 23, 2013
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12/05/2013

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Ozark-Dale County Public Library416 James StreetOzark, Alabama 36360Application for Employment
This application is intended for use in evaluating your suitability for employment. Pleaseanswer all questions completely and legibly. If a question is not applicable, indicate with a N/A.If you need more space to explain any answer, you may request an extra sheet of paper. False or misleading statements, whether oral or written, are grounds for refusal or termination of employment and benefits. All qualified applicants will receive consideration withoutdiscrimination on the basis of sex, marital status, race, age, creed, national origin, citizenship,the presence of non-job-related disabilities, or any other status protected under state or federallaw, and such information may be omitted from this form. A felony conviction will notnecessarily bar the applicant from employment. This application is not an employment contract.Additional testing of skills and other job-related characteristics, as well as testing for the presence of illegal drugs in your body, may be required before an offer of employment is made.Once such an offer has been made, you may be required to undergo a medical review todetermine your suitability for the position for which you applied. This review would include thecompletion of a medical history form and may include an examination by a medical professional designated by the company.
PERSONAL DATA
Street City State Zip Code Since (month/year)Street City State Zip Code Since (month/year)Street City State Zip Code Since (month/year) Name: Last, First, MiddleSocial Security Number Work Telephone Number Home Telephone Number 
Please list below your current address and your two other most recent addresses.AVAILABILITY
Position for which you are applying:Yes/No: Can you work?Part-time _____ Full-time _____ Either_____ Weekends _____ Evenings _____ Date available to start:
 
Please answer the following questions.If necessary, use an extra sheet of paper to provide explanations.
1. Are you at least 18 years of age?2. Are you willing to work overtime when necessary?3. Please list any restrictions you might have on your ability to work overtime.4. Are you on layoff and subject to recall?5. Are you currently party to any noncompetitive or trade secret agreement? (If yes, explain.)6. Have you ever been discharged or asked to resign from a job? (If yes, explain.)7. Have you ever been convicted or plead guilty to a felony or other crime? (If yes, explain.)High School Attended (or equivalency) City State Dates Attended (years) Diploma (Y/N)Undergraduate College Attended City State Dates Attended (years) DegreeUndergraduate College Attended City State Dates Attended (years) DegreeGraduate College Attended City State Dates Attended (years) DegreeTrade, Business, or Other School City State Dates Attended (years) Degree
EDUCATIONEMPLOYMENT EXPERIENCE
Most Recent Employer__________________________________________________________ Full Address____________________________________________ Telephone_____________ Position Held__________________________ Dates Worked from ___________to__________ Rate of Pay_______________ Supervisor___________________________________________ Reason for leaving_____________________________________________________________ Duties_______________________________________________________________________ Most Recent Employer__________________________________________________________ Full Address____________________________________________ Telephone_____________ Position Held__________________________ Dates Worked from ___________to__________ Rate of Pay_______________ Supervisor___________________________________________ Reason for leaving_____________________________________________________________ Duties_______________________________________________________________________ 

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