Employee Job Application
Personal Information (please print)
Social Security No:    xxx-xx-xxxx
First Name:   MI: Last name  
Address:  
City:   State:   Zip Code:  
Telephone:  
Email:  
 
Position Desired
(check all applicable boxes)		 Certifications
 Bus Driver  CDL  
 Computer Technician
 Custodian  Boiler License  
 Maintenance
 Para-Professional  48 credits    AA (60 credits)    BA    BS    CDA    Para-Pro Test  
 Payroll Supervisor
 Secretary
 
Education History
School/College Name/Location Dates Attended
(Yr to Yr)		 Degree &
Graduation Date		 Major & Minor
High School:
Undergraduate Study, College Or University:
Graduate Study,
College Or University:
Special Schools and Courses:
 
Work Experience
From
Month / Year		 To
Month / Year		 Name/Address/
Telephone of Employer 		Position
Held
 
Active Military Service (Not Reserve Status)
From
Month / Year		 To
Month / Year		 Months In Service Branch of
Service		 Job
Classification		 Rank
 
Professional References (DO NOT include relatives.)
Reference 1
Include Name, Address and Phone Number. 		Reference 2
Include Name, Address and Phone Number.
 
Acknowledgement and Release of Information
I understand that, at some point in the selection process, some or all of the information contained in this application could become public and the facts set forth herein are subject to verification.

I hereby authorize the West New York Board of Education to investigate my background as part of the application process. It is the intent of such authorization to provide full and free access to information for the specific purpose of pursuing a background investigation which may provide pertinent data for the West New York Board of Education to consider in determining my suitability for employment.

I understand that if I am employed by the West New York Board of Education, I will be required to submit to a state and national criminal history record check, and I will be required to submit to fingerprinting, at my expense, for purposes of submitting my fingerprints to the Federal Bureau of Investigation for a national criminal history check. I further understand and agree that if I have been convicted of a crime which has not been disclosed to the West New York Board of Education, the Board may immediately dismiss me.

I authorize any and all law enforcement agencies, current and former employers, and academic institutions to supply any information regarding my background to the West New York Board of Education, and to its agents and employees. In consideration of the West New York Board of Education’s review of this employment application, I hereby release the West New York Board of Education, its employees and agents, and all providers of information from any liability resulting from such investigation or furnishing and/or receiving such information.

I have read and understand the acknowledgement and release statement above and agree to its contents. I declare under penalties of false statement that I have examined this application and to the best of my knowledge and belief, the information contained herein is true, complete and accurate. I understand that falsification of information on this application form may be grounds for dismissal.

  Type your name to confirm your agreement

We are an Affirmative Action Equal Opportunity School District. The Board does not discriminate with respect to Age, Gender, Race, Creed, National Origin or Disability
  
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