Application for Employment s10

Application for Employment Westside Elementary Grade 5 We are an equal opportunity employer. We are dedicated to a policy of nondiscrimination in employment on any basis including race, creed, color, age, gender, religion, or physical handicap. Personal Information: (Please Print) Date______Name:______Last First Middle Address: ______Street City State Zip Code Phone Number:_(_____)______Employment Desired: Name three positions you would accept in the order of most preferred. ______

List the skills and abilities you have that make you a good choice for the positions listed above.

Employment History: Name at least two prior positions of employment (paid or volunteer): 1. ______Name of position (job held) Name of employer/company 2. ______Name of position (job held) Name of employer/company I understand that if employed, I must complete my duties and responsibilities during the work day when all of my school work is completed. I must consistently show good attendance and complete my duties in order to keep the position and receive my pay/wages.

Date______Signature of Applicant______