MIME-Version: 1.0 Content-Location: file:///C:/0C4BB24E/jobapplication.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" JOB APPLICATION

JOB APPLICATION

 

PINCKNEY COMMUNITY PUBLIC LIBRARY

Date of Interview

350 Mower Rd., = PO Box 379

Personnel Officer

Pinckney MI  48169

Director

Phone: 734-878-= 3888 Fax: 734-878-2907

 

 

Name

    =             &nb= sp;       Last        &= nbsp;           &nbs= p;         First        &= nbsp;           &nbs= p;            &= nbsp;        Middle Initial

Street Address

City    &= nbsp;           &nbs= p;            &= nbsp;            State        &= nbsp;       Zip        &= nbsp;           Ph= one

  1. Title of position for which you are applying
  3. Have you ever been employed by a library?
  5. What is your social security number?
  7. Are you a citizen of the United States?

 

Educational Background – Please give fu= ll information regarding your experience and education.  Answer in detail.  If more space is needed, attach additional sheets.

 

Circle Highest Grade Completed: Grammar School – 3= 4 5 6 7 8

    =             &nb= sp;            =             &nb= sp;        High School – 9 10 11 12

 

Name and Location of last school attended:

 

Did you graduate? =   Yes___ No____

 

Date you quit or graduated    Mo._____________ Yr._________________

 

Business College, trade school, night school or other.=

 

 

 

 

 

Name

Subject

Length of Course

Number of Classes/ Hours Per Week

Did you complete?

Date Completed?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name & Location of College/University

Major

Minor

Degree (s) Received

Dates Attended

Date Graduated

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Give title, number, date of issue, and expiration date of any occupational license, registration, certificate, or journeyman’s card, which you hold.

 

Give drivers license number and/or chauffeur’s lic= ense number if applicable

Was any of the education or experience claimed on this application obtained under a name other then the one used on this application?  Yes____ No_____.= If so, under what name?

Have you ever been convicted (that is fined, placed on probation, sentenced to jail or prison, or given a suspended sentence) for = any violation of law other than minor traffic violations?  Yes ___ No____.<= /p>

A conviction does not necessarily prevent employment.  Each case is considered on its own merits.  A false answer, howev= er, may result in disqualification or termination.  If you answer is “yes”, explain fully on an additional sheet, or your application will be rejected.=

 

Experience

Account for all your time in the past ten years and any earlier experience, which qualifies you for the position for which you are applying.  If more then one po= sition was held under the same employer, describe each position separately.  Periods not worked must also be indicated (military service, unemployed, etc.).  If more space is needed attach additional sheets.  For “= ;Your duties” describe in detail kind of work, responsibilities.  Be sure the sign the certificate a= t the bottom of the page.

Employer________________________________________________= ___________ From___________ To____________

Street Address____________________________________________________________________= _________________
City_________________________________________ State______ Zip__________ Phone#______________________

Your Title______________________________ Hours Worked Per Week___________________

Starting Salary_________ Last Salary______________<= /o:p>

Your Duties

Reason For Leaving

Employer____________________________ From___________ To____________

Street Address________________________________________________________
City_____________________ State______ Zip__________ Phone#______________________

Your Title______________________________ Hours Worked Per Week___________________

Starting Salary_________ Last Salary______________<= /o:p>

Your Duties

Reason For Leaving

Employer____________________________ From___________ To____________

Street Address________________________________________________________
City_____________________ State______ Zip__________ Phone#______________________

Your Title______________________________ Hours Worked Per Week___________________

Starting Salary_________ Last Salary______________<= /o:p>

Your Duties

Reason For Leaving

Certificate of Applicant:  I hereby certify that all informat= ion given in this application is true and agree and understand any misstatement= of material facts contained in this application may be grounds for termination= .  I further expressly agree my employment and compensation can be terminated wi= th or without cause or notice at any time, at the option of either the Library= or myself, it being understood that the employment relationship between myself= and the Pinckney Community Public Library is one of employment at will.  I further certify that this application is made under my correct legal name.

 

 

Date______________________ Signature_____________________________________________