Form - MCISD Application Form

CONTACT INFORMATION

First Name

Middle Initial

Last Name

Suffix

Address Line 1

Address Line 2

City, State, Zip

Email Address

Phone

Position Applied For:

How Did You Hear About The Position? Friend/Relative Indeed Social Media Advertisement Other

EDUCATION BACKGROUND

High School Name and Location of graduating high school

Graduated with a HS Diploma or Equivalent? (required) Yes No

Colleges/Universities Attended

Major/Minor

Credit Hours Earned

Degree(s) Earned

Certifications/Endorsements/Licenses

Dates Valid

EMPLOYMENT HISTORY

Employer - Current or most recent Include any job-related military service and volunteer activities. This information must be complete in order to process this application.

Employer Address (City, State)

Job Title

Dates Employed (From/To)

Hourly Rate/Salary (Starting/Final)

Reason For Leaving

Employer

Employer Address (City, State)

Job Title

Dates Employed (From/To)

Hourly Rate/Salary (Starting/Final)

Reason For Leaving

PROFESSIONAL REFERENCES

Name three persons (not personal, or related to you) who can provide information about your work performance, attendance, work ethic, etc.

Professional Reference #1 Name/Phone Number

Professional Reference #2 Name/Phone Number

Professional Reference #3 Name/Phone Number

CONSENT TO CHECK REFERENCES: I hereby authorize the Menominee County ISD to contact any references whose names I have submitted as well as any other person who may be familiar with my previous job performance or suitability for employment, and to discuss my willingness and ability to perform the job for which I am applying. I also release this School District and any of the persons providing information from any liability or legal claims for making such contact or from using or providing any of the information obtained. I hereby waive any right that I may have against any person contacted by Menominee County ISD including former employees who provide information concerning this application and I release each said person from liability for providing information.

I have read the information above and give my consent for reference and employment checks per MCISD policies. (required) Yes No

Are you eligible to work in the United States? Yes No

Are you 18 years of age or older? Yes No

Have you applied for a position with us before? Yes No

May we contact your present employer? Yes No

Can you travel if the position requires it? Yes No

Have you been convicted of a felony within the last 7 years? If yes, please explain.

If hired, what date would you be available to start?

APPLICANT STATEMENT: I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application or interview(s) shall be considered sufficient cause for dismissal. I understand, also, that I am required to abide by all rules and regulations of the employer. I understand that unless this application is completed in detail it will not be considered. I certify that I can perform the essential elements of the job for which I am applying. I understand that the Menominee County ISD is required by law to conduct a criminal background check to determine acceptability for employment. If I am offered a position with the district, I will fulfill the requirements for a completion of a criminal records check through the Menominee County ISD.

I have read and agree to the Applicant Statement. (required) Yes No

NAME

DATE

Upload Documents Please upload any supporting documents: cover letter, resume, transcripts, certifications/licenses, letters of recommendation, etc.

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