Four County Area Vocational Cooperative
1607 Dowling Street
Kendallville, IN 46755
Garrett-Keyser-Butler Community School District (LEA)
APPLICATION FOR EMPLOYMENT
Classified Personnel
Date of Application:
Last Name:
First Name:
Middle Name:
Email Address:
Street Address:
City/State:
Zip Code:
Telephone:
Social Security Number:
Position Desired:
Have you ever filed an application with us before?
If yes, please give the date:
If yes, please tell us what position you applied for:
Have you ever been employed with us before?
If yes, please give dates of employment:
Are you currently employed?
If yes, may we contact your present employer?
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?
Proof of citizenship or immigration status will be required upon employment.
On what date would you be available for work?
Have you ever been arrested?
If yes, please explain:
Are you physically or otherwise unable to perform the duties of the job for which you are applying? Please explain any limitations you may have.
EMPLOYMENT EXPERIENCE
Start with your present or last job. Include and job-related military service assignments and volunteer activities. You may exclude organizations, which indicate race, color, religion, gender, national origin, handicap or other protected status.
Employer:
Supervisor:
Address (including city/state/zip):
Telephone:
Job Title:
Dates Employed:
Salary:
Reason(s) for leaving:
Work performed:
Employer:
Supervisor:
Address (including city/state/zip):
Telephone:
Job title:
Dates Employed:
Salary:
Reason(s) for leaving:
Work performed:
Employer:
Supervisor:
Address (including city/state/zip):
Telephone:
Job Title:
Dates employed:
Salary:
Reason(s) for Leaving:
Work Performed:
Please continue on a separate sheet of paper if you need additional space.
SPECIAL SKILLS AND QUALIFICATIONS
Summarize special job-related skills and qualifications acquired from employment or other experience:
EDUCATION
Elementary School Name and Location:
Please check years completed:
High School Name and Location (including area of study):
Please check years completed:
Undergraduate College/University Name and Location (include degrees earned):
Please check years completed:
Graduate College/University Name and Location (include degrees earned):
Degree/Years Completed:
Describe any specialized training, apprenticeship, skills and extra-curricular activities:
Describe any honors you have received:
State any additional information you feel may be helpful to us in considering your application:
List professional, trade, business or civic activities and offices held. You may exclude memberships, which would reveal sex, race, religion, national origin, age ancestry or handicap or other protected status:
Please give the name, address and phone number of no less than three references who are not related to you and are not previous employers:
APPLICANT STATEMENT
I certify that the answers given are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in
writing by an authorized executive of this organization.
In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand also that I am required to abide by all rules and regulations of the employer.
I agree with the terms of this statement of application:
Applicant's Name (signature of agreement):
Applicant's Social Security Number (signature of agreement):
Please use this file upload tool for transcripts, resumes, cover letters or other materials for application:
Please use this file upload tool for transcripts, resumes, cover letters or other materials for application:
Please use this file upload tool for transcripts, resumes, cover letters or other materials for application:
FCAVC is an equal opportunity employer.
