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USD357 Classified Staff Employment Application
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* Indicates required question
First Name
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Your answer
Last Name
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Your answer
Middle Name or Initial
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Your answer
Email Address
With a valid email address you will receive a copy of your application.
Your answer
First Contact Number
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Example: 123-456-7890
Your answer
Second Contact Number (Optional)
Example: 123-456-7890
Your answer
Third Contact Number (Optional)
Example: 123-456-7890
Your answer
Street Address
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Your answer
City
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Your answer
State
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Your answer
Zipcode
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Examples: 12345 or 12345-6789
Your answer
Position Applying For:
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Para Educator
Secretary
Custodian
Technology
Coach
Substitute Teacher
Food Service
Maintenance
Bus Driver
Nurse
Daycare Director
Transportation Director
Have you read the job description listing the qualifications, responsibilities, and physical requirements?
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Are you able to perform the essential functions of this position with or without reasonable accommodations?
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Why do you wish to work in this district/position?
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Would you accept temporary or part-time employment?
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Would you like to be added to the substitute list for this position?
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Date Available
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MM
/
DD
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YYYY
Expected Hourly Salary
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Your answer
Educational & Professional Training
High School Name, Location
*
Your answer
College Name, Location, Degree or Training
Your answer
Other Educational or Professional Training
Your answer
Record of Work Experience
Please list the jobs that you have held. List most recent job in the first space.
Name of Firm or Organization, Address, Phone Number, Supervisor's Name, Dates Employed (1)
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Your answer
Reason for leaving above position (1)
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Your answer
Name of Firm or Organization, Address, Phone Number, Supervisor's Name, Dates Employed (2)
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Your answer
Reason for leaving above position (2)
*
Your answer
Name of Firm or Organization, Address, Phone Number, Supervisor's Name, Dates Employed (3)
Your answer
Reason for leaving above position (3)
Your answer
Name of Firm or Organization, Address, Phone Number, Supervisor's Name, Dates Employed (4)
Your answer
Reason for leaving above position (4)
Your answer
Have you ever been placed on probation, discharged or asked to resign from a place of employment?
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Yes
No
References
In naming references, give preference to supervisors and co-workers who are familiar with your professional work. Do not use relatives as references. These people may be contacted by telephone or by written correspondence. At least three recent references are requested.
Ref #1: Name and Title
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Your answer
Ref #1: Contact Number
*
Example: 123-456-7890
Your answer
Ref #1: Address
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Your answer
Ref #2: Name and Title
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Your answer
Ref #2: Contact Number
*
Example: 123-456-7890
Your answer
Ref #2: Address
*
Your answer
Ref #3: Name and Title
Your answer
Ref #3: Contact Number
Example: 123-456-7890
Your answer
Ref #3: Address
Your answer
Have you ever been convicted of a Misdemeanor?
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No
Have you ever been convicted of a Felony?
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Yes
No
Have you ever been placed on diversion or had deferred criminal proceedings involving moral turpitude?
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Moral turpitude includes, but is not limited to; theft, attempted theft, murder, rape, swindling, and indecency with a minor.
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Yes
No
Do you presently have pending any violations of law other than minor traffic violations?
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If yes, please explain on next page. State the nature of the crime(s), when and where convicted and disposition of the case.
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