Vinton County Local School District 307 West High Street McArthur, Ohio 45651 Phone (740) 596-521 8 Fax (740) 596-3142 APPLICATION FOR EMPLOYMENT - NON-TEACHING POSITIONS This application is for all non-teaching (classified) positions with the Vinton County Local School District and will remain active for 90 days after which you must reapply. If you wish your application to be considered for a specific position you will need to submit a written letter o f intent for a specific vacancy. Date: Name: (First)

(Middle)

(Last)

Mailing Address: (Number and street or P.O. Box)

(city)

Daytime Phone:

(state)

(zip)

Evening Phone:

Email address: List any other name(s) by which you are o r have been known by: Have you previously worked for the Vinton County Local School District?

No

Yes

Position:

Supervisor's Name:

Location:

Date o f Separation:

Do you have any relatives currently employed by the Vinton County Local School District or serving on the Vinton County Local School Board o f Education? Yes(see below)

No

Name

Relationship

Position

Name

Relationship

Position

full time

shift schedule

part-time

flex schedule

temporary

substitute

cafeteria worker

custodial

classroom aide

secretarial

bus driver

maintenance

bus mechanic

tutor

What type of employment do you seek?

What type of work do you seek? (check all that apply)

Do you have a valid CDL License'?

Yes

No

Do you have a valid Ohio driver's license?

Yes

No

State and number:

Expiration Date:

Education:

-Yes

-No

GED

Yes

-No

College Graduate

Yes

-No

High School Graduate

Name of High School (including city and state):

College or University:

Degree:

Major and/or Minor:

Additional qualifications (i.e. specialized training, trade or professional organizations):

List three references who are not related to you. Include your most recent supervisor.

Name

Address

City

State

Zip

Phone

Name

Address

City

State

Zip

Phone

Name

Address

City

State

Zip

Phone

I'HL V I N ['ON C O U N T Y SCI 1001. DIS I KICT IS AN FOI IAI. OIJI'OR I ' i l N I SV CVlPI,OYLK

Background inforrnntion: "YES" answers to any ofthe following questions will not necessarily result in denial of employment. The District will consider all the circumstances, including the date and nature of the events that have led to the actions described below. Your written explanation will assist the District in determining your eligibility, qualifications and suitability for employment. Attach additional sheets if necessary.

1.

Have you ever been convicted of, pled guilty or no contest to, or are you awaiting trial for any crime excluding minor traffic violations involving a tine of less than S200.00? If you answer "YES" you must provide the dates of the proceedings, the court where the proceedings occurred, a description of the accusation against you and the final disposition of the case(s). NO

2.

Explanation:

YES

Explanation:

Are you now being investigated for any alleged nlisconduct or other alleged grounds for discipline by any licensing, certification or other regulatory body (examples: teacher certification, child care licensing) or by your current or any previous employer? If you answer "YES" you must provide the name, address and telephone number of the employer or licensing body and a description of the accusations against you. NO

5.

YES

Have you ever had any employment or business-related license or certificate of any kind (examples: teaching or child care license) revoked or suspended, or have you in any way been sanctioned by, or is any charge or complaint now pending against you before, any licensing. certification or other regulatory agency or body public or private? If you answer "YES" you must provide the dates of the proceedings; the name, address and telephone number of the agency or body; a description of the accusations against you; and the final disposition. NO

4.

Explanation:

Have you ever been dismissed, terminated, non-renewed or fired from any job, or resigned at the request of your employer or while charges against or an investigation of you was pending? You must answer "YES" even if the matter was later resolved with any form of settlement or severance agreement, regardless of its terms. Ifyou answer "YES" you must provide the date your eniploynient ended, the name, address and telephone number o f the employer(s) and a statement describing the matter. You are not required to answer "YES" if your non-renewal or termination was pursuant to a reduction in force or layoff.

NO

3.

YES

YES

Explanation:

Are you authorized to work in the United Statcs?

--

NO

--YES

I I l l : V I N FON COUNTY SCIIO( )I. 111S1RICT IS A N EQ1fAI. OITl )l