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Saline County Arkansas

 

Saline County Library

Application for Employment

 


 

Mail or Fax Application to:

 

Saline County Courthouse

% Personnel Office

200 N. Main Street - Room 112

Benton, AR  72015

Phone Number:  501-303-5658

Fax Number:      501-315-1338

 

 

Application for Employment

 

Date:   _______________________

 

Name:_________________________________________________________________

          Last                                            First                                       Middle

 

Address: _______________________________________________________________

                Street                            City                                State                Zip

 

Home Phone:  ____________________  Social Security #: ______________________

 

Position applied for:__________________  Salary/Hourly rate desired: ______________

 

On what date would you be available to begin work?____________________________

 

Are you available to work: 

Full Time ______  Part Time ______  Flexible ______  Nights ______  Saturdays ______

 

Are you employed now? _______

 

Education

 

_____________________________________________________________________

High School Name

_____________________________________________________________________

Dates Attended

_____________________________________________________________________

Describe Course of Study

_____________________________________________________________________

Diploma/Degree

_____________________________________________________________________

College or University or other

 

Can you type? Yes ____  No _____  

If yes, how many words per minute with no mistakes? __________________

 

Are there any other special skills, training or qualifications you have acquired that you feel especially suit you for the work at the Saline County Library?  _________________________________________________________________________

 

_________________________________________________________________________

 

Give name , address and telephone number of three professional references.

___________________________________________________________________________

 

___________________________________________________________________________

 

___________________________________________________________________________

 

 

In case of emergency please notify:  ________________________________________________

 

Work Experience

 

List below your prior work experience, start with your present or last job.  If there is not enough space, you can make as many copies of this page as you need.  Include volunteer work and military service assignments.

 

1. __________________________________________________________________

    Name of Employer                                    Address

    __________________________________________________________________

    Job Title                                                    Supervisor's Name

    __________________________________________________________________

    Dates Employed                                        Last Salary

    __________________________________________________________________    

    Describe Job Duties

    May we contact this employer?     Yes_____      No _____

 

2. __________________________________________________________________

     Name of Employer                                    Address

    __________________________________________________________________

    Job Title                                                    Supervisor's Name

    __________________________________________________________________

    Dates Employed                                        Last Salary

    __________________________________________________________________    

    Describe Job Duties

    May we contact this employer?     Yes_____      No _____

 

3. __________________________________________________________________

     Name of Employer                                    Address

    __________________________________________________________________

    Job Title                                                    Supervisor's Name

    __________________________________________________________________

    Dates Employed                                        Last Salary

    __________________________________________________________________    

   

Describe Job Duties:  __________________________________________________

    May we contact this employer?     Yes_____      No _____

 

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

 

In the event of employment, I understand that false or misleading information given in my application or interviews may result in discharge.  I understand, also, that if employed I will be required to abide by all rules and regulation of the library.

 

Signature:  ____________________________________________

 

Date:          ____________________________________________

 

AUTHORIZATION FOR RECORD CHECK

 

Position Desired:  ______________________________________

 

PLEASE PRINT FULL NAME CLEARLY (Including Middle Initial)

 

_____________________________________________________

 

Social Security Number:  __________________________________

 

Current Address:  ________________________________________

 

City:  _________________________ State:  _____  Zip:  __________

 

Previous Address (If less than three years at current address):

________________________________________________________

________________________________________________________

 

Maiden/Previous Names:  _____________________________________

 

I, ______________________________, do hereby authorize the Benton Police Department or the Bryant Police Department to search their police records for any conviction (s) they may have regarding me, and to make this information available to the Saline County Library.

 

The Saline County Library is an equal opportunity employer.

 


 

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