Application for Employment

GENERAL                                                                           

PLEASE ENTER YOUR EMAIL ADDRESS:    
NAME (FIRST) (M.)(LAST)(SUFFIX)
* *
PRESENT STREET ADDRESSAPT / PO BOX #
*
CITYSTATEZIP CODE
* *
CONTACT ADDRESS (IF DIFFERENT FROM PRESENT ADDRESS)
PHONE NO. PHONE NO. (EVE) PHONE NO. (ALT)
*
HAVE YOU PREVIOUSLY WORKED FOR THE WAYNE COUNTY PUBLIC LIBRARY? *
ARE YOU RELATED TO A CURRENT WAYNE COUNTY PUBLIC LIBRARY EMPLOYEE? *
IF HIRED CAN YOU PROVIDE PROOF OF CITIZENSHIP OR LEGAL RIGHT TO WORK? *
HAVE YOU BEEN CONVICTED OF A FELONY IN THE LAST SEVEN (7) YEARS? *
A conviction will not necessarily disqualify an applicant from employment.

POSITION                                                                                                                        

PLEASE LIST THE SPECIFIC OPEN POSITION YOU ARE APPLYING FOR:*
POSITION DESIRED: WAGE OR SALARY EXPECTED:
DO YOU HAVE ANY PREVIOUS LIBRARY EXPERIENCE?
DESIRED START DATE:SOURCE OF REFERRAL:
CAN YOU WORK EVENINGS? WEEKENDS? SUNDAYS?
LIST DAYS AND HOURS AVAILABLE TO WORK:

EMPLOYMENT RECORD - List most recent employment first                                      

EMPLOYER: EMPLOYER ADDRESS:
START DATE:END DATE: FINAL TITLE:
POSITION DESCRIPTION:FINAL SALARY:
SUPERVISOR'S NAME: PHONE:
REASON FOR LEAVING: MAY WE CONTACT THIS EMPLOYER?
EMPLOYER: EMPLOYER ADDRESS:
START DATE:END DATE: FINAL TITLE:
POSITION DESCRIPTION:FINAL SALARY:
SUPERVISOR'S NAME: PHONE:
REASON FOR LEAVING: MAY WE CONTACT THIS EMPLOYER?
EMPLOYER: EMPLOYER ADDRESS:
START DATE:END DATE: FINAL TITLE:
POSITION DESCRIPTION:FINAL SALARY:
SUPERVISOR'S NAME: PHONE:
REASON FOR LEAVING: MAY WE CONTACT THIS EMPLOYER?

EDUCATION AND TRAINING - Complete High School section if still in school          

COLLEGE, UNIVERSITY, OR TECHNICAL SCHOOLS:
SCHOOL NAME: CITY & STATE: GRADUATE:
TYPE OF DEGREE: MAJOR: GPA:
SCHOOL NAME: CITY & STATE: GRADUATE:
TYPE OF DEGREE: MAJOR: GPA:
OTHER SCHOOLING:
SCHOOL NAME: CITY & STATE: GRADUATE:
TYPE OF DEGREE: MAJOR: GPA:
HIGH SCHOOL LAST ATTENDED:
SCHOOL NAME: CITY & STATE: GRADUATE:
TYPE OF DEPLOMA: MAJOR: GPA:
EXTRACURRICULAR ACTIVITIES:
DID YOU EVER WORK IN THE SCHOOL LIBRARY?
IF YES, DESCRIBE:
LIST LICENSES, FOREIGN LANGUAGES, COMPUTER, DATA/WORD PROCESSING, OFFICE EQUIPMENT, TYPING, SHORTHAND, OR OTHER SKILLS & TRAINING YOU CONSIDER RELEVANT TO EMPLOYMENT AT WCPL:
 
PROFESSIONAL ORGANIZATIONS, ASSOCIATIONS, HONORS, CERTIFICATIONS, PROFESSIONAL LICENSES AND PUBLICATIONS YOU CONSIDER SIGNIFICANT AND JOB RELATED. PLEASE INDICATE THE PROFESSIONAL LICENSE NUMBER AND STATE OF ISSUANCE (OPTIONAL):

LANGUAGE ABILITY -- LIST THOSE YOU COULD USE IN YOUR WORK:
ENGLISH: SPEAK READ WRITE       : SPEAK READ WRITE

CLICK HERE TO ATTACH A RESUME OR OTHER SUPPORTING DOCUMENTATION (OPTIONAL)

REFERENCES                                                                                                               

LIST THREE PERSONS OTHER THAN RELATIVES OR PERSONAL FRIENDS WHO HAVE KNOWLEDGE OF YOUR WORK EXPERIENCE AND/OR EDUCATION.

NAME/TITLE: PHONE:
MAILING ADDRESS:
NAME/TITLE: PHONE:
MAILING ADDRESS:
NAME/TITLE: PHONE:
MAILING ADDRESS:

AUTHORIZATION - APPLICATION MUST BE SIGNED PRIOR TO SUBMITTING              

I agree to the conditions below and verify that all information on this application is correct.
* You must agree to the conditions to continue.

I hereby authorize investigation of all statements contained in this application and on my resume, if provided. I certify that such statements are true to the best of my knowledge and understand that misrepresentation or omission of facts called for in this form, or on any resume provided to me, may be cause for rejection or cause for termination of employment without notice if employed. I also understand this application is not a contract or offer of employment and that only the Director of the Wayne County Public Library or his/her designee can make an offer of employment with the WCPL.

I understand this application is valid only for the position for which I have applied. A new application would need to be completed and submitted for consideration to be given for another open position at the Wayne County Public Library. I also consent that WCPL may contact references, former employers, and educational institutions listed regarding this application and may perform a criminal background check. I agree that any claim or lawsuit relating to my service with WCPL must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I wave any statute or limitations to the contrary. If you are hired, this employment application will become part of your official employment record.

SIGNATURE (PLEASE TYPE YOUR NAME):* DATE:*

NO PERSON SHALL BE DENIED EMPLOYMENT ON THE BASIS OF RACE, COLOR, ETHNICITY, NATIONAL ORIGIN, SEX/GENDER, SEXUAL ORIENTATION, RELIGION, CREED, DISABILITY (INCLUDING HIV STATUS), AGE, VETERAN STATUS, OR MARITAL STATUS.

Employment is contingent upon furnishing evidence of identity and employment eligibility.

Last revised April 2008






A COPY OF THE APPLICATION CAN ALSO BE DOWNLOADED IN .PDF FORMAT [HERE].

COMPLETED APPLICATIONS CAN BE MAILED TO:
WAYNE CO. PUBLIC LIBRARY
c/o JUDI KIZZEN
304 N. MARKET STREET
WOOSTER, OH 44691