The
EMPLOYMENT APPLICATION FOR SERVICE AND SUPPORT PERSONNEL
We consider applicants for all positions without regard to
race, color, national origin, age, religion, sex, martial status, veteran or
military status, disability, or any other legally protected status.
An Equal Opportunity Employer
Personal Data
Date of Application:
____________________ Social
Security Number:
_____________________________
Name:
_______________________________________________________________________________________
Last First Middle Name
Current Address:
______________________________________________________________________________
Street/Box City State Zip Code
Other Address Where You May Be Reached:
________________________________________________________
Work Phone:____________________ Home Phone:____________________ Cell Phone:____________________
Other Name That May Appear On Records:
_________________________________________________________
(Used for certification, reference, & criminal history record
checks)
Position Data
List the position(s) you are applying for: ____________________________________________________________
Type of Employment: ❑ Full-time ❑ Part-time
❑ Summer Only
Date You Can Begin Work: __________________________________
Have you been employed by the Cuero ISD
in the past? ❑ Yes ❑ No
If you answered yes, provide the dates
of employment: ________________________________________________
Education/Training
Check the highest level of education attained:
❑ Not a high school graduate (circle last
grade completed) 1 2
3 4 5
6 7 8
9 10 11
12
❑ High school graduate ❑
GED
❑ Two or more years of college ❑ Bachelor’s Degree ❑ Master’s Degree
❑ Other training or education:
___________________________________________________________________
Licenses and/or certificates held:
_________________________________________________________________
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Name
and location of schools
attended |
Course
of study and major/minor |
Diploma,
degree, certificate, or license held |
Year
graduated |
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Page 2
EMPLOYMENT APPLICATION FOR SERVICE AND SUPPORT PERSONNEL
Work Experience
Please provide a complete list and all positions you have held in the past 10 years. List the most recent first. Attach additional sheets if necessary (bus driver applicants, see addendum). Attach resume if available.
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Employer and Location |
Position/ Title |
Dates Employed |
Reason for Leaving |
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Do you have any physical conditions that would limit your
capacity in this job? ❑ Yes
❑ No
If yes, please explain: __________________________________________________________________________
List specific skills and any machines or equipment you can operate. Include typing speed and number of years experience.
1. __________________________________________ 2.
________________________________________
3. __________________________________________ 4.
________________________________________
5. __________________________________________ 6.
________________________________________
Do
you have a valid Driver’s License? ❑ Yes ❑ No Type:
__________ License Number:
________________
Do
you have a relative who serves on the Cuero ISD Board of Education? ❑ Yes ❑ No
If yes, please provide the relative’s name and relationship: _____________________________________________
_____________________________________________________________________________________________
Have you ever been convicted of, plead guilty or no contest (nolo contender) to, or received probation, suspension, or deferred adjudication for a felony or any offense involving moral turpitude (including, but not limited to, theft, rape, murder, swindling, and indecency with a minor)? ❑ Yes ❑ No
If
yes, please state where, when, and the nature of the offense: ___________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(A felony conviction is not an automatic bar to employment. The District will consider the nature, date, and relationship between the offense and the position for which you are applying.)
Page 3
EMPLOYMENT APPLICATION FOR SERVICE AND SUPPORT PERSONNEL
Please
list references the District can contact regarding your work history. Please include all managers and supervisors
who evaluated or supervised your performance at your last two employers.
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Full name of reference |
School district/ Firm name |
Mailing Address |
Position/ Title |
Area code, Phone Number |
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I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment.
I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing the same to you.
I understand that the district is authorized by Texas Education Code §22.083 to obtain criminal history record information on applicants the district intends to employ.
_____________________________________________ ________________________
This application becomes the property of the District. The District reserves the right to accept or reject it. This application shall be considered active for 24 months. If you have not received a response during this time period, you may reapply or reactivate your application.