Augusta County Food Service employment Application AUGUSTA COUNTY SCHOOL BOARD FOOD SERVICE DEPARTMENT

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Augusta County Food Service employment Application AUGUSTA COUNTY SCHOOL BOARD FOOD SERVICE DEPARTMENT Powered By Docstoc
					                      Augusta County Food Service employment Application
                              AUGUSTA COUNTY SCHOOL BOARD
                                FOOD SERVICE DEPARTMENT
                                        6 John Lewis Road
                                   Fishersville, Virginia 22939
     Telephone (540) 245-5127                                                   Fax     (540) 245-5174


Date Submitted                                      Social Security Number

Name
                 (Last)                        (First)                           (Middle or Initial)
Present Address



Telephone          Home                             Cell                          Work

Check Positions you are applying for:    Cafeteria Manager                   Food Service Worker
                Substitute Worker        Full-time (4 ½ to 6 hrs.)           Part-time (3 to 4 hrs.)

Please X the following schools in which you would be willing to work. You may also number them
to indicate schools of higher preference.

BGHS                      FDHS          RHS                 SDHS                   WMHS
BMMS                      SMS           SDMS                BME                    Cassell
Clymore                   Ladd          NRE                 RES                    Craigsville
SDE                       Stump         VES                 WES                    Churchville

Education: List all schools you have attended:
                                           Dates of        Diploma, Degree         Major Courses or
    School          Name & Location       Attendance        Or Certificate       Areas of Specialization

High School

Business College

Technical School

College

References:     Give names and addresses of three people who know you and your work.
                Please do not list relatives.
              Name                            Address           Phone Number      Occupation

1.

2.

3.

                                  AN EQUAL OPPORTUNITY EMPLOYER
Work Experience:
Present or Last Position
Company/Business:                                                   Phone Number:
Address:
Employed From:                                                 To
                        (Month)              (Year)                   (Month)               (Year)
Immediate Supervisor:
Type of work performed:

Next Previous Position
Company/Business:                                                   Phone Number:
Address:
Employed From:                                                 To
                        (Month)              (Year)                   (Month)               (Year)
Immediate Supervisor:
Type of work performed:

Describe your level of skills in working with computers.


Describe any other work or community experiences related to food preparation.


Why do you wish to make a change if you are presently employed?


When could you begin this job?

If you answer yes to any of the following, please explain on a separate sheet of paper and attach
to application.
 Have you ever been discharged or requested to resign from a position?                      No       Yes
 Have you ever been convicted of a violation of law other than a minor traffic violation?   No       Yes
 Are any criminal charges or proceedings pending against you?                               No       Yes
 Have you been convicted of any offense involving the sexual molestation, physical or
   sexual abuse, or rape of a child?                                                        No       Yes
 Are you related to the Superintendent of Schools or any current Augusta County
   School Board member?                                                                     No       Yes

I hereby certify that all the facts and information given are true and accurate to the best of my
knowledge. Also, I authorize the Augusta County School division to investigate my past
employment and references.

 DATE                                                 SIGNED

Applications shall be accepted and the applicant given careful consideration regardless of race, sex, age,
national origin, handicap, or religious belief.

				
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