WALLACE SCHOOL DISTRICT
 PO Box 267, Silverton, ID 83867
 (208) 753-4515

APPLICATION FOR CLASSIFIED EMPLOYMENT
An Equal Opportunity Employer

Name_______________________________________________Social Security Number____________________________

Address_____________________________________________Telephone Number________________________________

Position(s) Applied For_________________________________________________________________________________

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WORK EXPERIENCE
Name of Current Employer			Address		Supervisor’s Name and Title

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Dates Employed     Rate of Pay		Telephone		Reason for Leaving

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Job Titles and Duties

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Name of Previous Employer		Address		Supervisor’s Name and Title

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Dates Employed      Rate of Pay		Telephone		Reason for Leaving

____________________________________________________________________________________________________
Job Title and Duties

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Name of Previous Employer		Address		Supervisor’s Name and Title

____________________________________________________________________________________________________
Dates Employed      Rate of Pay		Telephone		Reason for Leaving

____________________________________________________________________________________________________JJob Title and Duties

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May our district representative contact your present employer?  _____yes _____no

Are you willing to work split shifts, part-time and/or weekends?_____yes _____no

EDUCATION and PROFESSIONAL TRAINING
High School		Year Graduated		GED

College: No. of Years/Trade School	Year Graduated		Degree In

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List any special training or skills that may qualify you for this position_______________________________________

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Are you prevented from lawfully being employed in this country because of Visa or immigration status?

_____yes______no  (Proof of citizenship will be required upon employment)

Have you ever been dismissed for immoral or unprofessional conduct?_____yes _____no

Have you ever been convicted of a criminal offense other than a traffic violation? _____yes _____no
(A background investigation will be required upon employment)

If you answered yes to the above question, please explain and identify the type of offense and jurisdiction________

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REFERENCES

	NAME		ADDRESS			TELEPHONE
1.
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2.
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3.
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THIS APPLICATION WILL NOT BE CONSIDERED UNLESS ALL QUESTIONS ARE ANSWERED AND THE APPLICATION IS SIGNED.

I certify that the answers herein are true to the best of my knowledge.  I hereby authorize an investigation of any or all statements contained in this application as may be necessary at arriving at an employment decision.

I understand and acknowledge that any employment relationship with the district is of an “at will” nature , which means that the Employee may resign at any time and the Employer may discharge the Employee at any time with or without cause.  It is further understood that the disposition of this “at will” employment relationship may not be changed by any act unless such change is specifically acknowledged in writing by the Board of Trustees.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.  I understand, also, that I am required to abide by all rules and regulations of the employer.

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Signature of Applicant			Date