RML - Application for Employment
Roddenbery Memorial Library
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Email *
Date
MM
/
DD
/
YYYY
Name
Address
Telephone
Email Address
Do you have a PINES library card?
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Have you applied for a job with us before?  
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Please list any friends/relatives working here
Do you speak a language other than English?
Level of schooling completed:
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Position Applying For:
Pay Expected
Number of hours desired per week:
Days of the week you are available?
When would you be available to begin work?
MM
/
DD
/
YYYY
Skills: Please check all that apply
Column 1
Keyboarding
MS Office
Social Media
Mobile Devices
Ebooks
Podcasts
Cash/Credit Card Machine
Customer Service
Filing
Photocopiers
Scanning
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Name of Employer, address, telephone #, Name of Supervisor
Position, job duties, rate of pay, dates works, and reason for leaving
Name of Previous Employer, address, telephone #, Name of Supervisor
Position, job duties, rate of pay, dates works, and reason for leaving
Name of Previous Employer, address, telephone #, Name of Supervisor
Position, job duties, rate of pay, dates works, and reason for leaving
Reference 1: Please include Name, Relationship, Phone # and Title
Reference 2: Please include Name, Relationship, Phone # and Title
Reference 3: Please include Name, Relationship, Phone # and Title
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge.  I understand that if employed, false statements on this applications shall be considered sufficient cause for dismissal.  I understand that the Roddenbery Memorial Library has the right to review my previous employment and references as may be necessary in arriving at an employment decision.  
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