William F. Laman Public Library System

Position for which you are applying? *
Applying for? (Check All That Apply) *
Regular part-time eployment Regular full-time employment Temporary work - such as summer or holiday employment
Location (Check All That Apply) *
Main Library Argenta Branch Children's Department Teen Center Adult Department LINC Center (computer lab)
When are you available to start work? MM / DD / YYYY
Desired Salary (annual) $ Dollars . Cents
PERSONAL CONTACT INFORMATION
Name * First Last
Other names under which you have attended school or been employed
Current Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell Phone Number * ### - ### - ####
Home Phone Number (if different) ### - ### - ####
Email Address
BASIC EMPLOYMENT ELIGIBILITY
Are you over 18 years of age? *
Yes No
Do you currently have any family members employed at the library *
Yes No
If YES, please list their name and their relationship to you.
Are you a U.S. citizen, or otherwise authorized to work in the U.S. on an unrestricted basis? *
Yes No
Have you ever been convicted of a felony? *
Yes No
If YES, please fully describe the circumstances.
SUMMARY OF SKILLS

Please list technical skills, clerical skills, trade skills, etc., relevant to this position. Include relevant computer systems and software packages of which you have a working knowledge, and note your level of proficiency (basic, intermediate, expert)
Skills *
EDUCATION HISTORY

List your educational background and your level of completion or graduation.
Check all that apply: *
High School GED 2 or 4 year college Graduate School
High School or GED information *

Please supply:
Name of school
City and State
Date of completion or expected completion.
2 or 4 year college information as applicable

Please supply:
Name of the school
City and State
Year of completion or expected completion
Major course of study
Degree received.
Graduate school information as applicable

Please supply:
Name of the school
City and state
Year of completion or expected completion
Major course of study
Degree received.
Please read carefully and sign that you understand and accept this information:
I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize William F. Laman Public Library System to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of William F. Laman Public Library serve at-will, and the employment relationship may be terminated at any time by either party, for any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and State loyalty oath, and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits including paid time off. If employed on a regular, benefits-eligible basis, I understand that I would be required to make mandatory contributions to the William F. Laman Public Library Retirement System or to an optional retirement program, if applicable. I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice. I understand that the first SIX MONTHS of regular employment represent a provisional period, during which I would not be eligible to apply for transfer or promotion and during which I may be terminated without right of appeal.
*
Today's Date * MM / DD / YYYY
WORK EXPERIENCE

You will be given an opportunity to attach a copy of your complete resume, and other documents, at the end of this application. However, please also fill out this section as appropriate.

Please detail your work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Attach additional sheets if necessary. Omission of prior employment may be considered falsification of information. Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE DO NOT complete this information with the notation “See Resume.”

PLEASE NOTE: William F. Laman Public Library reserves the right to contact all current and former employers for reference information.
Current or most recent employer *

Please include:
Company Name
Address
Phone Number
Start and End Dates
Start and End Wage
Name of Supervisor (May we contact them?)
Job Responsibilities
Reason for Leaving
Prior Employer #2

Please include:
Company Name
Address
Phone Number
Start and End Dates
Start and End Wage
Name of Supervisor (May we contact them?)
Job Responsibilities
Reason for Leaving
Prior Employer #3

Please include:
Company Name
Address
Phone Number
Start and End Dates
Start and End Wage
Name of Supervisor (May we contact them?)
Job Responsibilities
Reason for Leaving
PERSONAL REFERENCES

You may list up to three (3) personal references. (Not former employers or relatives)
Personal Reference #1 First Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number ### - ### - ####
Personal Reference #2 First Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Personal Reference #3 First Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number ### - ### - ####
Attach Additional Documents (up to three)

You may include copies of your resume, cover letter, references, etc...
Attach a File
Attach a File
Attach a File
Submit this form....
Do Not Fill This Out

William F. Laman Public Library System

PERSONAL CONTACT INFORMATION

BASIC EMPLOYMENT ELIGIBILITY

SUMMARY OF SKILLS

EDUCATION HISTORY

Please read carefully and sign that you understand and accept this information:

WORK EXPERIENCE

PERSONAL REFERENCES

Attach Additional Documents (up to three)

Submit this form....