Kewanee CUSD #229 Application for Summer Employment (Not for Summer School Session)

Kewanee CUSD #229 Application for Summer Employment (Not for Summer School Session)

Equal access to programs, services and employment is available to all persons. Those applicants requiring accommodation to the application and/or interview process should contact a representative of the Personnel Department at 309-853-3341.

Position(s) applied for:
Date Date / MM / DD YYYY
Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Have you ever been employed here before?

Have you ever been employed here before? Yes No
If yes, give dates
Start Date: If yes, give dates
Start Date: / MM / DD YYYY
End Date: End Date: / MM / DD YYYY
Are you legally eligible for employment in this country? (Proof of U.S. Citizenship or immigration status will be required upon employment.)

Are you legally eligible for employment in this country? (Proof of U.S. Citizenship or immigration status will be required upon employment.) Yes No
Date available for work: Date available for work: / MM / DD YYYY
Have you been convicted of a felony in the last seven (7) years? (Such conviction may be relevant if job related, but does not bar you from employment. Applicant is not obligated to disclose sealed or expunged records of conviction or arrest.)

Have you been convicted of a felony in the last seven (7) years? (Such conviction may be relevant if job related, but does not bar you from employment. Applicant is not obligated to disclose sealed or expunged records of conviction or arrest.) Yes No
If yes, please explain:
Skills and Qualifications:

Summarize any special training, skills, licenses, certificates and/or characteristics of yourself that may qualify you as being able to perform job-related functions for the position which you are applying:
List any additional information you would like us to consider:
Reference #1

Name Reference #1

Name First Last
Phone Phone - ### - ### ####
Years Known
Reference #2

Name Reference #2

Name First Last
Phone Phone - ### - ### ####
Years Known
Reference #3

Name Reference #3

Name First Last
Phone Phone - ### - ### ####
Years Known
Employment History:

Employer #1
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Job Title
Immediate Supervisor and Title Immediate Supervisor and Title First Last
Summarize the nature of the work performed and job responsibilities:
Reason for leaving
May we contact for reference?

May we contact for reference? Yes No
Employer #2

Name
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Job Title
Immediate Supervisor and Title Immediate Supervisor and Title First Last
Summarize the nature of the work performed and job responsibilities:
Reason for Leaving
May we contact for reference?

May we contact for reference? Yes No
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature.

It is understood and agreed upon that any misrepresentation by me on this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed.

I give the employer the right to investigate all references and to secure additional information about me, if job-related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

The employer is an Equal Opportunity Employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state or federal law.

This application is current for one year. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that just as I am free to resign at any time, the employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the employer has the authority to make any assurances to the contrary.

I understand that this company's policy not to refuse to hire an qualified individual with a disability because of this person's need for an accommodation that would be required by the ADA. Clear

Full Name

I understand this is a legal representation of my signature.

It is understood and agreed upon that any misrepresentation by me on this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed.

I give the employer the right to investigate all references and to secure additional information about me, if job-related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

The employer is an Equal Opportunity Employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state or federal law.

This application is current for one year. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that just as I am free to resign at any time, the employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the employer has the authority to make any assurances to the contrary.

I understand that this company's policy not to refuse to hire an qualified individual with a disability because of this person's need for an accommodation that would be required by the ADA.
Date Date / MM / DD YYYY