Position(s) for which you are applying:
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Date of application
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How did you learn about this job:
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Name
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Please include Middle initial with first name
First Name
Last Name
Phone
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(###)
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Email
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Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Are you at least 18 years old:
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Please indicate your availability:
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Date you can report to work:
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Do you have a valid Oregon driver's license:
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Have you ever had any license or certification suspended or revoked:
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Are you a veteran:
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Are you legally eligible for employment in the United States (at the time of employment):
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Did you graduate from high school or receive an equivalent diploma:
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Name of college or university attended, if any:
From (mo/yy) To (mo/yy). Year of Graduation.
Degree(s)/certificated(s) earned:
Please identify any specialized training, licenses and or certificates, experience with machines, office equipment, and/or other special skills relevant to the position for which you are applying:
A job description for the position(s) for which you are applying has been provided. Are you able to perform the essential job functions required of the position with or without reasonable accommodation(s):
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Supervisor's name and title:
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Reason for leaving:
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May we contact this employer?
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Supervisor's name and title:
Reason for leaving:
May we contact this employer?
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Supervisor's name and title:
Reason for leaving:
May we contact this employer?
Have you ever been terminated from a job or asked to resign?
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Reference 1
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Give us the name, relationship, address, and phone number of reference 1
Reference 2
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Give us the name, relationship, address, and phone number of reference 2
Reference 3
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Give us the name, relationship, address, and phone number of reference 3
Applicant Certification and Acknowledgement
I certify that all statements made in connection with this application whether contained herein (and/or in any supplements) or made by me or others at my request during the course of the employment process) are true and complete in all respects. I acknowledge and agree that any incorrect, incomplete, false, fraudulent, or misleading statements made by me, either verbally or in writing, and/or any omission, concealment, or failure to answer any question fully, completely, and accurately, whether made by me or others at my request, will result in rejection of this application, denial of employment, or termination from employment if discovered after employment. If I am employed by the district I agree to comply with its lawful orders, rules, policies, and regulations. I authorize the investigation of all matters which the district deems relevant to my qualifications for employment, including, without limitation, work records, reference checks, education, and an investigation into my driving record. I authorize and request that all my present and former employers, references, educational institutions, and any others to furnish and release information about me, my employment record, and/or education, including a statement of reasons for the termination of my employment and information regarding my work performance, disciplinary reports or actions, abilities, degrees obtained, transcripts, licenses and certifications, and other qualities and information the district deems pertinent to my qualifications for employment. By signing below, I release the district (and all providers of information) from any and all claims and/or liabilities arising out of or in any way connected with district’s background investigation. If employed, I release the district from any claims and/or liabilities for future references it may provide regarding my work history and performance with the district.
I understand that if offered employment, I will be required to submit proof of my identity and legal right to work in the United States as a condition of employment. I understand that, if employed, my employment relationship with the district will be at-will. Therefore, subject to applicable law, my employment may be terminated (and I may voluntarily resign) at any time, for any reason or no reason, with or without cause or prior notice. Nothing contained in this application, or provided in connection herewith, will be construed as an offer or promise of employment, nor does this application create an employment contract or guarantee that employment or any benefit will be provided or continued for any period of time.
By signing below, I hereby affirm the foregoing and all other contents of this application. My signature below certifies that I have read and understand this application and agree to the terms and conditions contained in this application.
Applicant Signature:
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Date:
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