AN EQUAL OPPORTUNUITY EMPLOYER

Application for Non-Teaching Position

Marshall Public School District

860 W. Vest

Marshall, MO 65340

(660) 886-7414

We afford equal opportunity to qualified individuals regardless of their age, race, color, national origin, ancestry, religion, socio-economic status, marital status, sex, handicaps or memberships in legally constituted organizations to the extent required by all applicable laws.

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POSITION DESIRED

Secretary Paraprofessional (please attach college transcript documenting at least 60 credit hrs)	Custodial Maintenance	Nurse Bus Driver Other
Specific Position of Interest:

PERSONAL INFORMATION

Name		Date of Application
Home Address Home Telephone Number
E-mail Address (Optional)	Date available for employment

Are you a United States citizen or able to work legally in this country? Yes No

Have you ever been convicted of a crime? Yes No

Are you presently under contract with any school district for next year? Yes No

Are you presently employed? Yes No

If yes, may we contact your present employer? Yes No

WORK EXPERIENCE

NOTE: Begin with most recent

Name/Location

Period of Service

Type of Work

Reason for Leaving

REFERENCES

List three references who are qualified to answer questions concerning your fitness for the position you seek.

Name

Present Address

Phone Number

Official Position and Dates Acquainted With Your Work

EDUCATION

Institution	Name & Location of School	Years Attended	Date of Graduation
Grammar School
High School
College
Business or Trade School

QUESTION: In your own handwriting, please write a short statement as to why you are interested in this position and why you feel you would be a good candidate. Attach additional paper if needed.

AGREEMENT

I hereby certify that the above information to the best of my knowledge is true, accurate and complete. Any misrepresentation or willful omissions of facts shall be sufficient cause for disqualification of this application or termination of employment. Furthermore, it is understood that this application and records become the property of the Marshall Public School District which reserves the right to accept or reject it. I further agree to observe all rules, regulations and policies of the Marshall Public School District now in force and effect or as they may change during my employment, if I am employed by the District. I also hereby authorize the District to conduct a background investigation and authorize release of information in connection with my application for employment. This investigation may include such information as criminal convictions, driving records, previous employers and educational institutions, personal references, professional references and other appropriate sources. I waive my right of access to any such information, and without limitation hereby release the school district and the reference source from any liabilities in connection with its release or use.

( ) I request that this application and consideration of same be kept confidential.

Date Signature of Applicant