Job Application Form - Non Certified Employment Application

NON CERTIFIED EMPLOYMENT APPLICATION 2020-2021

Please complete the form below to apply for a position with us.
Date*

MonthDayYear
Full Name*

First NameMiddle NameLast Name
Position sought*
Available start date:*
Hours you can work?*

Full TimePart TimeSubstitute
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email Address*

EDUCATION*

	School attended	Graded attended	Graduated?

JOB HISTORY*

	Employer	Phone	Position	Dates	Reason for leaving

REFERENCES*

	Name	Address	Phone	Relationship

Have you ever been convicted of a felony or child abuse?*

YesNo
If yes, please explain:
Have any court ever received a plea of guilty or a pleas of nolo contendere from you for any offense, deferred further proceedings without entering a finding of guilty, and/or placed you on probation?*

YesNo
if yes, please explain:
Have you ever been convicted of, pled nolo contendere to, or received a deferred sentence for a crime involving unlawful behavior or unlawful sexual behavior involving a child?*

YesNo
Have you ever been involuntarily terminated from any employment?*

YesNo
If yes, please explain:
I have been provided with a copy of the job description and understand the requirements of the position for which I am applying. I represent that I am physically capable of performing the physical requirements of this position as stated in the job description. I grant my prospective employer full authority to verify application from information via driverʼs record, workerʼs compensation, criminal history, index, and registry files. I certify that the information given by me on this application is true and correct to the best of my knowledge. I
understand that false statements on this application including false statements regarding my physical abilities may result in termination
of employment.
Signature

Clear
Manitou Springs School District 14 is an equal opportunity educational institution and will not discriminate on the basis of race, color, national origin, ancestry, creed, religion, sex (which includes marital status), sexual orientation, disability, age, genetic information or conditions related to pregnancy or childbirth in its activities, programs or employment practices as required by Title VI, Title I, and Section 504. For information regarding civil rights or grievance procedures, contact Dr. Elizabeth Domangue, Superintendent of Schools, Manitou Springs School District 14, 405 El Monte Pl., Manitou Springs, CO 80829, (719) 685-2024, edomangue@mssd14.org or the Office of Civil Rights, U.S Dept of Education, 1961 Stout Street, Denver, CO 80294, (303) 844-2991.
Upload resume as a pdf

Upload a File

Cancelof
APPLICATIONS ARE KEPT ON FILE FOR ONE YEAR FROM
DATE OF SIGNATURE
Should be Empty:

NON CERTIFIED EMPLOYMENT APPLICATION 2020-2021