FARMINGTON CENTRAL CUSD #265
APPLICATION FOR EMPLOYMENT - AN EQUAL OPPORTUNITY EMPLOYER

Any job offered is conditional upon your ability to establish employment under the Immigration Reform and Control Act of 1986.

The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.

The District does not require the submittance of a photo to file this application.

Email Address *
Date of Application
MM
/
DD
/
YYYY
Name *
Last, First, Middle, Maiden
Present Address *
Primary Telephone *
Letter of Interest, Resume and Two (2) Letters of Recommendation (Please attach these documents)
Have you ever interviewed for work at Farmington Central CUSD #265? *
Under What Name?
What position did you interview for?
Have you ever worked for Farmington Central CUSD #265 before? *
Under What Name?
What position did you hold?
Education: List highest grade completed or highest degree obtained. *
1-18
Educational History *
Please list all educational history, including a list of schools attended (name + address), # of years completed, and any major/degree.
Other Training
Additional Qualifications *
Please identify any additional knowledge, skill, or qualification that will be helpful to us in considering your application for employment.
Certified Applicants: Attach a Copy of Your Transcripts
Please attach a copy of all transcripts (if hired official transcripts will be required)
Certified and Student Facilitator Applicants: Attach a Copy of Your Valid Illinois PEL
What job opening are you applying for? *
In the event there is more than one job opening listed, you may include another that you would be interested in applying for.
In the event there is more than one job opening listed, you may include another that you would be interested in applying for.
Other Job Classifications that you would be interested in applying for should an opening become available. (Check all that apply)
Certified - Grade Levels Qualified For (Check all that apply)
Certified - Areas You Are Endorsed to Teach (Check all that apply)
Have you ever been convicted of a crime? *
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Have you ever been determined a perpetrator of child abuse or neglect in a Department of Children and Family Services ("DCFS") report? *
If yes, explain.
1. Work History - Most Recent Employer *
*List most recent employer first.
1. Work History - Most Recent Employer *
May we contact this employer?
1. Work History - Most Recent Employer *
Employer Address and Phone.
1. Work History - Most Recent Employer *
Name of Supervisor.
1. Work History - Most Recent Employer *
Your Job Title and Salary
1. Work History - Most Recent Employer *
Dates of Employment
1. Work History - Most Recent Employer *
Reason For Leaving
2. Work History - Next Recent Employer
*List next most recent employer.
2. Work History - Next Recent Employer
May we contact this employer?
2. Work History - Next Most Recent Employer
Employer Address and Phone.
2. Work History - Next Most Recent Employer
Name of Supervisor.
2. Work History - Next Recent Employer
Your Job Title and Salary
2. Work History - Next Recent Employer
Dates of Employment
2. Work History - Next Most Recent Employer
Reason For Leaving
3. Please list any other work history relative to the position you are applying for.
Personal Reference #1 *
Give below the name and phone number of a persons not related to you whom you have known in a professional capacity at least one year and have personal knowledge of your fitness as an employee.
Personal Reference #2 *
Give below the name and phone number of a persons not related to you whom you have known in a professional capacity at least one year and have personal knowledge of your fitness as an employee.
Personal Reference #3 *
Give below the name and phone number of a persons not related to you whom you have known in a professional capacity at least one year and have personal knowledge of your fitness as an employee.
Additional Information
Please summarize any additional information necessary to describe your qualifications for the specific position you are applying for.
Did you complete this application yourself? *
Candidates Statement:
Each candidate is asked to provide any additional information that is pertinent to this application and will assist the district in evaluating the candidate's qualifications (i.e., personal qualities, future goals, awards, travel, involvement in community activities, etc.). It is imperative that your answers and explanations are complete.
Certification: Please enter name in box to indicate agreement with the following statement. *
I hereby certify that the information given by me in this application is true, correct and complete; and, I hereby authorize personnel in the district to examine my records and contact any of my schools, former employers or other references for the purposes of collecting information regarding my employment, education, certification, experience and fitness as an employee. I authorize such schools, former employers or other references, and any current or former officers, agents or employees thereof to disclose information regarding my employment, education, experience and fitness as an employee, and I agree to hold any and all of such schools, former employers, references and persons harmless and free of any liability for releasing any truthful information about me. I understand that failure to provide any information requested in this application which is material to my qualifications for employment or the provision of statements which I do not believe to be true may be a Class A Misdemeanor. For purposes of this application, I shall be deemed to have made a false statement if I make a statement which I do not believe to be true or if I knowingly omit or fail to include any information required to be furnished on this application. I understand that if I am employed, any false or misleading statement made or implied on this application, any omission of required information, or any inconsistency between the information I have provided herein and information obtained from any criminal history records check, Statewide Sex Offender Database check, Statewide Child Murderer and Violent Offender Against Youth Database check, or other background investigation may result in immediate dismissal. I further understand that my employment or continued employment is contingent upon the District’s receipt of a criminal history records report which is acceptable to the Board of Education.
Applicants are encouraged to reapply each year.
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