Champaign County Library Job Application
Library staff play an integral role in helping the library serve our community and endeavoring to meet their information needs. The Champaign County Library is looking for driven, dedicated, and professional people to help make our library a friendly and patron-minded place for the people of Champaign County.
First Name *
First and last name
Your answer
Last Name *
Your answer
Street Address *
Your answer
City, State, Zip *
Your answer
Email *
Your answer
Phone number *
Your answer
Which position(s) are you interested in? *
Required
1. Employer (most recent) *
Your answer
Dates Employed *
Your answer
Work Performed *
Your answer
2. Employer
Your answer
Dates Employed
Your answer
Work Performed
Your answer
3. Employer
Your answer
Dates Employed
Your answer
Work Performed
Your answer
Are you over the age of 18? (If under 18, hire must provide proof of eligibility to work) *
Have you ever been employed with us before? If yes, give approximate dates, position and department. *
Your answer
Do any of your friends or relatives work for the Champaign County Library? *
If you are currently employed, may we contact your employer? *
Are you legally eligible to work in the United States? (Proof of citizenship or immigration status will be required upon employment) *
When would you be available to start? *
MM
/
DD
/
YYYY
When are you available to work? Check all that apply. *
Required
What level of education have you completed? Check all that apply. *
Required
Please provide the name of the school(s) and specific degrees earned. *
Your answer
Describe any additional job-related skills and qualifications.
Your answer
Please list 2 professional references with name, company, address, phone number and relationship (e.g. supervisor, co-worker). *
Your answer
Applicant's Statement: I certify that the information provided by me on this application for employment is true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. *
Resume (optional)
Please send resume and/or cover letter to

Ty Henderson, Director
thenderson@champaigncountylibrary.org

Champaign County Library
1060 Scioto Street
Urbana, OH 43078
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