ARP INDEPENDENT SCHOOL DISTRICT by bfs10682

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									                  ARP INDEPENDENT SCHOOL DISTRICT
                                          P.O. Drawer 70
                                         Arp, Texas 75750
                                          (903) 859-8482
                               An Equal Opportunity Employer
                                 EMPLOYMENT APPLICATION
                                           FOR
                             NON-PROFESSIONAL PERSONNEL

I. PERSONAL DATA
Date of Application :______/_______/________ Date Available: _______/_______/________

Name:_______________________________________________________________________________
                           Last                          First                           Middle


Address:_____________________________________________________________________________
            Street / Box                     City                              State                Zip


Social Security: ___________/_________/___________

Work Phone:_____________________________ Home Phone:_______________________________

Type of position(s) for which you are applying:____________________________________________

Credentials included with application:

_____Resume

_____Other:___________________________________________________________

Are you a former employee of Arp ISD? _____No            _____Yes (please list dates of employment)

                                                                    _______/_______/__________

II. EDUCATION / TRAINING

   High School College or          Dates      Major              Minor Field           Type of     Degree
         University               Attended    Field of            of Study              Degree    Earned?
       and Location                            Study                                   Received
III. OTHER WORK EXPERIENCE

Please write below a complete listing of all jobs you have held in the last 10 years. Please attach
resume, if available, stating responsibilities in detail.

  School District or              Position              Dates Employed           Reason for Leaving
     Firm Name




IV. GENERAL INFORMATION

Do you have any physical or health impairments that would limit your ability to perform the job
for which you are applying?
                                     _____Yes                      _____No

If yes, please explain___________________________________________________________________

How many days have you lost as a result of personal illness during the last three (3) years?________

Do you have a relative who is either a member of the Arp ISD Board of Education or who is
employed in any capacity in the Arp ISD?

                                       _____Yes                        _____No

       Name of Relative:______________________________________________________________

       Relationship:__________________________________________________________________

       Position Held:_________________________________________________________________

Have you ever been convicted of a felony? _____Yes                     _____No

If yes, please explain:_________________________________________________________________

Have you ever been asked to resign or been discharged through due process from any position,
teaching or otherwise?

                       _____Yes                        _____No

If yes, please explain:_________________________________________________________________
V. EMPLOYMENT REFERENCES

Please list below references who may be contacted regarding your work history.

School District or      Mailing Address                 Phone               Immediate              Dates of
   Firm Name                                                                Supervisor            Employment




VI. PERSONAL STATEMENT
Please make a statement in your own handwriting concerning your reasons for desiring a position
with the Arp Independent School District.

_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________


_____________________________________________________________________________________________________________________

VII. VERIFICATION
I hereby affirm that all information provided in this application is true and accurate to the best of
my knowledge. I understand that, if employed, any falsified information may be considered
sufficient cause for dismissal. You are authorized to make an investigation of my education and
work history.


                                             ________________________________________________
                                             Legal Signature of Applicant                       Date
                CRIMINAL HISTORY RECORD INFORMATION

The Arp Independent School District is REQUIRED BY STATE LAW to obtain criminal history
record information on all applicants for employment with the district (Texas Education Code
Chapter 22, Subchapter C).

I understand the information set forth below will be used by the district solely for the purpose of
obtaining criminal history information and will not be used in any manner related to determining
eligibility for employment with the district.




Full Legal Name:______________________________________________________________________
                     Last                    First                  Middle         Maiden




Social Security Number: _________/_______/_________ Date of Birth: _______/_______/__________



Sex: ______Male               ______Female           Driver’s License ______________________
                                                                            (State & Number)




Ethnicity: _______Black       ______White    ______Hispanic         ______Other




                                             _____________________________________________
                                             Signature


                                             __________________________________
                                             Date

								
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