Download 1500 Meredith Ave. Gustine, CA 95322

GUSTINE UNIFIED SCHOOL DISTRICT
1500 Meredith Ave.
Gustine, CA 95322
(209) 854-3784
Drug Free/Smoke Free Workplace Employer
PLEASE TYPE OR PRINT
Name:
APPLICATION FOR EMPLOYMENT
CLASSIFIED PERSONNEL
___________________________________________________ SSN:__________________________
Address
City
State
Zip
PERSONNEL USE ONLY
Date Hired:
________________________________
Classification:
________________________________
Range: ________________ Step: ___________________
Date Application Received: __________________________
Do you have any physical conditions or handicaps, which
need accommodation?
Yes: _______No:_____
Phone (Home): ________________________________ (Message): ___________________________________
Comments: _______________________________________
________________________________________________
Position applying for: ________________________________________________________________________
Were you ever discharged or force to resign from a
If hired, date you can begin work:_______________________________________________________________
position?
Please comment on languages (other than English) that you speak, read or write fluently: ___________________
If yes, Please Explain: ______________________________
________________________________________________
Do you possess a valid California Driver’s License?
Yes:
______
No: _____
Do you have a valid bus driver’s certificate?
Yes:
______
No: _____
Have you ever been convicted of a felony or misdemeanor that resulted in imprisonment,
probation, or a fine in excess of $500?
Yes:
______
No: _____
If yes, please indicate where, when, the nature of the offense, and the disposition of the case on a separate piece of
paper and attach it to this application. PLEASE NOTE: A conviction will not automatically disqualify you from the
job, but falsifying your application can jeopardize your employment.
Have you applied to this school district before?
Yes:
______
No: _____
If yes, please state when and for what position: _____________________________________________________
Does this district currently employ you?
Yes:
______
No: _____
Other Comments: ____________________________________________________________________________
Check skills you possess pertaining to position applied for:
______ Accounting
______ Stock Clerk
______ Bookkeeping
______ Equip. Operator
______ Filing
______ Janitor/Custodian
______ Shorthand
______ Carpentry
_____ wpm
______ Maintenance
______ Typing
______ Plumbing
_____ wpm
______ Welding
______ 10 Key Touch
______ Electrical
______ Computer
______ Painting
______ Payroll
______ Grounds
______ Secretarial
______ Gardening
______ Personnel
______ Drive School Bus
______ Cafeteria
______ Other (explain)
__________________________________________________________________________________________
________________________________________
________________________________________
__________________________________________________________________________________________
Computer Programs: _______________________________
__________________________________________________________________________________________
________________________________________
________________________________________
__________________________________________________________________________________________
EDUCATION
NAME OF SCHOOL
LOCATION
___________________________________
___________________________________
Graduated High School/College
MAJOR
UNITS
___________
_________________
___________
___________
_________________
___________
Date
Diploma/Degree
_______________________________________
___________
_______________________________________
___________
A.
B.
C.
D.
Give complete information for each employment during the past 5 years – a
separate resume is not acceptable for this purpose.
Show your present and most recent job first.
Use a separate block for each job title; even those with the same employer.
Include U.S. Military schooling or training.
Employer:
Address:
Phone:
Employer:
Address:
Phone:
Employer:
Address:
Phone:
E.
F.
IN ORDER FOR YOUR APPLICATION TO BE GIVEN
FURTHER CONSIDERATION, correct names, addresses, and
phone numbers must be furnished for all references.
If you require additional space, please attach a separate piece of
paper.
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
Job Title: _________________________________
Supervisor: _________________________________
Duties:
_________________________________
_________________________________
_________________________________
_________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
Job Title: _________________________________
Supervisor: _________________________________
Duties:
_________________________________
_________________________________
_________________________________
_________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
Job Title: _________________________________
Supervisor: _________________________________
Duties:
_________________________________
_________________________________
_________________________________
_________________________________
For reference purposes, do we have your consent to contact any or all of the employers listed on this application?
Name
REFERENCES
Address
From
To
Salary
To
Salary
To
Salary
Reason for Leaving:
From
Reason for Leaving:
From
Reason for Leaving:
Yes: _____
No: ______
Do Not Write Here
Phone
Mail Received
I understand and agree that any misstatements or omissions of material fact by me in this application will be sufficient cause for cancellation of the application
and/or separation from the school district’s service. Placement on the salary schedule is contingent upon verification of training and work experience. If required,
I must pass a physical examination. Before this school district may employ any classified employee, fingerprints must be taken and cleared through the
Department of Justice. The first six months of employment are a probationary period, during which time I can be released without further explanation. If
employed, I further agree to abide by all general and safety rules of the school district. Gustine Unified School District is a drug and smoke free workplace, and I
will not use drugs or smoke on district property.
Date: ________________________
Signature of Applicant: _______________________________________