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Classified Application 14

Classified Application 14

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Published by: anon-579447 on Oct 23, 2008
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07/28/2013

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Lincoln County School District #2222 E. 4
th
AvenueP.O. Box 219Afton, WY 83110(307) 885-3811
Fax (307) 885-9562
CLASSIFIED EMPLOYEE APPLICATION
Last Name/ First/ MiddleDatePresent AddressE-mail AddressCity/State/ZipHome PhoneMobile PhonePosition applied for Date available for workEDUCATIONName of High School & LocationCollege/University & Area of StudyCircle Year Completed9 10 11 12Circle Year Completed1 2 3 4EMPLOYMENT EXPERIENCEPlease list all experience of three months or longer. Begin with the most recent. Attach an extra sheet if needed.Name of Business & LocationDates InclusivePositionReason for LeavingMAY WE CONTACT YOUR PRESENT EMPLOYER? YES
NO
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REFERENCESPlease list three to five persons who can answer questions concerning your qualifications for the position youseek. Include supervisors under whom you have worked. The district reserves the right to contact persons notspecified by you. Submission of an application to the district constitutes your permission and consent for thedistrict to contact any person(s) and discuss you, your qualifications, and other pertinent matters.Name/TitleRelationshipAddressTelephone NumbePursuant to the provisions of W.S. 21-7-401, any employee who is to be hired by the school board on or after July1, 1996, who may have access to minors is required to submit to fingerprinting and to provide any other information as is necessary to acquire a national criminal history background check. Are you willing to submit tothe necessary criminal and history background checks?YesNo
Conviction of a crime is not an automatic bar to employment. The district will consider the nature of the offense, the date of the offense, and the relationship between the offense and the position for which you are applying.
1. Have you ever been involuntarily terminated or asked to resign from any job?YesNo2. Have you ever been convicted of an offense other than a minor traffic violation?(DUI and DWI convictions are not considered minor and must be reported.)YesNo3. Have you ever been arrested for a felony? (Even if no contest or chargesdropped or pled down.)YesNo4. Have you ever been charged with a felony? (Even if no contest or chargesdropped or pled down.)YesNo5. Have you ever been convicted of a felony? (Even if no contest or chargesdropped or pled down.)YesNo6. Have you ever been arrested for a sex-related offense? (Even if no contest or charges dropped or pled down.)YesNo7. Have you ever been charged with a sex-related offense? (Even if no contest or charges dropped or pled down.)YesNo8. Have you ever been convicted of a sex-related offense? (Even if no contest or charges dropped or pled down.)YesNo9. Have you ever been arrested for a drug-related offense? (Even if no contest or charges dropped or pled down.)YesNo
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