Paris Independent Board of Education

310 W. 7th Street, Paris, Kentucky40361

Phone (859) 987-2160 Fax (859) 987-6749

Classified Personnel

Employment Application

Date

Personal

Name / SS No.
Address
City / State / Zip
Phone No. / ( ) / Alternate No. / ( )
Previous States of Residency and dates lived there:
Are you a U.S. Citizen? / Y / N / Are you age 18 or over? / Y / N
Have you been convicted of a felony or misdemeanor? / Y / N / Date(s)

(FOR THIS TYPE OF EMPLOYMENT, STATE LAW REQUIRES A STATE CRIMINAL HISTORY BACKGROUND CHECK AS A CONDITION OF EMPLOYMENT PLUS A NATIONAL CRIMINAL HISTORY BACKGROUND CHECK IS REQUIRED FOR APPLICANTS WHO HAVE RESIDED IN KENTUCKY TWELVE MONTHS OR LESS, EFFECTIVE: 6/1/05.)

Interest

What position is of interest to you?

Employment History

1. Employer: / Dates Employed: / Work Performed:
Address:
Job Title: / Hourly Rate / Salary / Reason for Leaving:
Starting / Final
$ / $
Supervisor:
2. Employer: / Dates Employed: / Work Performed:
Address:
Job Title: / Hourly Rate / Salary / Reason for Leaving:
Starting / Final
$ / $
Supervisor:
3. Employer: / Dates Employed: / Work Performed:
Address:
Job Title: / Hourly Rate / Salary / Reason for Leaving:
Starting / Final
$ / $
Supervisor:

Education

Paris Board of Education requires a minimum of a high school education; a GED; or sustained progress toward obtaining a GED as a condition of employment.

GED Certificate / Yes / No / Progress toward a GED
High School Diploma / Yes / No / Name of High School
College / Numbers of Years Completed
Or Numbers of Hours Completed

References

These persons should be qualified to give information on your fitness for the position you seek.

Name / Address / Occupation / Business Phone

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all laws, regulations, and policies of the Commonwealth of Kentucky, Kentucky Department of Education, and Paris Independent Board of Education.

Signature of Applicant / Date

I hereby give the Paris City Police Department and other agencies permission to release any and all police records to the ParisIndependentSchoolSystem.

Signature of Applicant / Date
Please Print Name / Social Security Number

Optional Information: (This section is not required for consideration of employment. The ParisIndependentSchool District seeks to draw applicants from all racial and ethnic groups in society. If you wish to identify yourself to the administration as a member of a particular group, please check the appropriate block. If the following categories do not fully describe your background, you may wish to check more than one and provide a description under “other”.)

White / Black/African-American / Native Hawaiian or Other Pacific Islander
Asian / American Indian or Alaska Native / Hispanic or Latino
Other
(Optional) / Gender: / Male / Female
(Optional) / Date of Birth:

The Paris Independent Board of Education selects employees on the basis of qualifications for the available vacancy regardless of applicant’s race, color, national origin, age, religion, gender or disability (Civil Rights Act of 1964). Please contact Gary Wiseman, Supt. @ 310 W. 7th St., Paris, KY40361 or (859)987-2160 if you have questions/ inquiries regarding the non-discrimination policy.