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Southwest Public Libraries Job Application Form
Personal Information
    
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Street Address (*)
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City (*)
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State (*)
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Zip (*)
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Phone (*)
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Cell Phone (*)
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Email Address
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Education Information
    
High School Name (*)Invalid Input
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Additional Information
    
What position are you applying for? (*)
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Location Preference (*)
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Type of work wanted? (*)
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Ability to use keyboard (*)
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Words per minute
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Can you with a minimal accommodation perform the essential functions of this job? (*)
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If you answered "No" above, please explain (*)
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Do you have relatives who work for the Southwest Public Libraries? (*)
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If you answered "Yes" above, please explain
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Affirmation of ability to work in the United States. "I attest, under the penalty of perjury that I am eligible to work in the US." (*)
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Are you over the age of eighteen (18) years? (*)
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During the last (10) years, have you ever been convicted of an offense other than a minor traffic offense? (*)
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If you answered "Yes" above please explain
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Work/Volunteer History
    
Instructions: List all employment/volunteer experience beginning with present or most recent.
May we contact your present and past employers? (*)Invalid Input
    
DatesName/Address/Phone of EmployerJob TitleDescribe Major DutiesReason For Leaving 
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References (List three non-relatives)
Name (*)Street Address (*)City (*)State (*)Zip (*)Phone (*)Years Known (*)
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Southwest Public Libraries is an equal opportunity employer and affords equal opportunity for all positions without regard to race, color, religion, gender, national origin, age, veteran status, medical condition, handicap, or any other status protected under local, state, or federal laws.
I voluntarily affirm that: The foregoing information in answer to each of the questions in this application is accurate and complete to the best of my knowledge; I understand that any falsification or willful misrepresentation is grounds for refusal of/or dismissal from employment; I give Southwest Public Libraries the right to verify all references and statements I have made in this application. Without contract to the contrary all those employed by the Southwest Public Libraries will be employed “At Will.” I agree to comply with all employment rules and regulations of the Southwest Public Libraries, and I indemnify and hold harmless all persons providing or receiving verbal or written information pursuant to this application. All applications will remain active for ninety day, reapplication after this time would be necessary. I understand that all employment offers with Southwest Public libraries are contingent on a satisfactory background check.
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