Lead Hill School District - Online Application

Lead Hill School District

Online Application

06.19.13

[Visitor Login]

Step :

Items denoted with a red asterisk * are required.

Personal Information

Name

First Name

M.

Last Name

First Name / Last Name

Address

Address 1

Address 2

City

State

Zip Code

Phone

- -

(XXX)-XXX-XXXX

Cell Phone

- -

(XXX)-XXX-XXXX

Email Address

Date Available

Click to View Date Picker

Social Security Number

Current Salary

* Position Applied for

High School Teacher Elementary Teacher
Pre-School Teacher Counselor
Principal Superintendent
Teacher Aide Maintenance
Custodial Bus Driver
Secretary Bookkeeper
Cafeteria Nurse

Are you a citizen of the United States?

Yes No

If no, are you authorized to work in the US?

Yes No

Have you ever worked for the Lead Hill School District?

Yes No

If yes, when and in what capacity?

Have you ever been convicted of a felony?

Yes No

If yes, please explain

Education

High School Attended

High School Attended

Address

Address 1

Address 2

City

State

Zip Code

Did you graduate?

Yes No

Diploma, GED, other

College Attended

College Attended

College Attended

Address

Address 1

Address 2

City

State

Zip Code

Address

Address 1

Address 2

City

State

Zip Code

Address

Address 1

Address 2

City

State

Zip Code

Did you graduate?

Yes No

Degree

Degree

Degree

Vocational Education

Address

Address 1

Address 2

City

State

Zip Code

Did you graduate?

Yes No

Degree

References

Reference

First Name

M.

Last Name

First Name / Last Name

Relationship

Company

Phone

- -

(XXX)-XXX-XXXX

Address

Address 1

Address 2

City

State

Zip Code

Reference

First Name

M.

Last Name

First Name / Last Name

Relationship

Company

Phone

- -

(XXX)-XXX-XXXX

Address

Address 1

Address 2

City

State

Zip Code

Reference

First Name

M.

Last Name

First Name / Last Name

Relationship

Company

Phone

- -

(XXX)-XXX-XXXX

Address

Address 1

Address 2

City

State

Zip Code

Employment History

Most Recent Employment

Address

Address 1

Address 2

City

State

Zip Code

Phone

- -

(XXX)-XXX-XXXX

Supervisor

First Name

M.

Last Name

First Name / Last Name

Job Title

Starting Salary

Ending Salary

Responsibilities

Start Date

Click to View Date Picker

End Date

Click to View Date Picker

Reason for Leaving

May we contact this employer?

Yes No

Previous Employer

Address

Address 1

Address 2

City

State

Zip Code

Phone

- -

(XXX)-XXX-XXXX

Supervisor

First Name

M.

Last Name

First Name / Last Name

Job Title

Starting Salary

Ending Salary

Responsibilities

Start Date

Click to View Date Picker

End Date

Click to View Date Picker

May we contact this employer?

Yes No

Reason for Leaving

Previous Employer

Address

Address 1

Address 2

City

State

Zip Code

Phone

- -

(XXX)-XXX-XXXX

Supervisor

First Name

M.

Last Name

First Name / Last Name

Job Title

Starting Salary

Ending Salary

Responsibilities

Start Date

Click to View Date Picker

End Date

Click to View Date Picker

Reason for Leaving

May we contact this employer?

Yes No

Previous Employer

Address

Address 1

Address 2

City

State

Zip Code

Phone

- -

(XXX)-XXX-XXXX

Supervisor

First Name

M.

Last Name

First Name / Last Name

Job Title

Starting Salary

Ending Salary

Responsibilities

Start Date

Click to View Date Picker

End Date

Click to View Date Picker

Reason for Leaving

May we contact this employer?

Yes No

Military Service

Branch

Enlistment Date

Click to View Date Picker

Date of Discharge

Click to View Date Picker

Rank of Discharge

Type of Discharge

If other than honorable, please explain

Disclaimer and Signature

By submitting this form you are providing an electronic signature that is providing the same permissions as a signed original.

Acknowledge
Does not acknowledge

Signature

Date

Click to View Date Picker

We are an Equal Opportunity Employer

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