JOB APPLICATION
Regional Office of Education (ROE) 1
507 Vermont St., Quincy, Illinois 62301
217-277-2080

Regional Office of Education 1 is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

PLEASE FILL OUT ALL OF THE SECTIONS BELOW:

Applicant Information
Applicant Name: *
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Address: *
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City, State and Zip Code: *
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Telephone Number: *
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Email Address: *
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Date of Application: *
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Employment Position
Position(s) applying for: *
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How did you hear about this position? *
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On what date can you start working if you are hired? *
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Do you have reliable transportation to and from work? *
Personal Information
Are you a U.S. citizen or approved to work in the United States? *
What document can you provide as proof of citizenship or legal status? *
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Job Skills/Qualifications
Please list below the skills and qualifications you possess for the position for which you are applying: (Note: Regional Office of Education 1 complies with ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.) *
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Education and Training
High School Name *
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High School Location (City, State) *
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High School Year Graduated *
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High School Degree Earned *
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Education and Training
College/University Name
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College/University Location (City, State)
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College/University Year Graduated
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College/University Degree Earned
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Education and Training
Vocational School/Training Name
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Vocational School/Training Location (City, State)
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Vocational School/Training Year Graduated
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Vocational School/Training Degree Earned
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Previous Employment
Employer Name *
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Job Title *
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Supervisor Name *
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Employer Address *
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Employer Telephone *
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Dates Employed *
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Reason for Leaving *
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Previous Employment
Employer Name
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Job Title
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Supervisor Name
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Employer Address
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Employer Telephone
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Dates Employed
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Reason for Leaving
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Previous Employment
Employer Name
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Job Title
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Supervisor Name
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Employer Address
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Employer Telephone
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Dates Employed
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Reason for Leaving
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References
Please provide 3 personal and professional reference(s) below:
Reference #1 Name *
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Reference #1 Contact Information *
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Reference #2 Name *
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Reference #2 Contact Information *
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Reference #3 Name *
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Reference #3 Contact Information *
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AT-WILL EMPLOYMENT
The relationship between you and the Regional Office of Education 1 is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without case, with or without notice, by you or the Regional Office of Education 1. No representative of ROE 1 has authority to enter into any agreement contrary to the foregoing "employment at will' relationship. You understand that your employment is "at will", and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Regional Superintendent or Assistant Regional Superintendent.
Applicant E-Signature *
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Date *
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