Please complete and return to:Date______
Walton County School District
Personnel Department
Position Desired______
145 Park St., Suite 3
DeFuniak Springs, Fl 32433
850-892-1101 Fax 850-892-1190
Walton County School District
Application For Employment
Non-Instructional
Dear Applicant:
Thank you for your interest in seeking employment with the Walton County School District. This application will be placed in our active employment file for a period of one year. If you still desire to be considered for employment after one year, you will need to submit an updated application at that time. The Walton County School District is an Equal Opportunity Employer and a Drug Free Workplace.
All information contained in this application is public information subject to disclosure under the provisions of Florida Statutes, Section 119.07, except as may be specifically excluded by this statute. A copy of Florida Statutes 1012.31, which governs personnel files of school board employees, is available to each employee upon request.
We are an Equal Opportunity Employer. We do not discriminate on the basis of race, religion, color, sex, marital status, age, national origin or disability. Employment of personnel in Walton County School District is in compliance with Federal and State Laws regarding nondiscrimination and preference. Individuals with disabilities are encouraged to apply. Any person who believes he/she may need reasonable accommodations during the application, testing or interview process should notify the Human Resources Office at 850/892-1100, extension 1306.
Name______
First MiddleLast
Phone #______
Address at which you can be contacted:
______
Street or P.O.CityStateZip
Have you applied to this school system before? _____ Yes _____No
Have you worked for this school system before? _____ Yes _____No If yes, when? ______
Year
RECORD OF EDUCATION
High School: ______Address:______
B. A. Degree: _____Yes _____No; Name of College______
Masters Degree: _____Yes _____No; Name of College______
Other ______
Specific honors/distinctions:______
Additional Skills(i.e. typing, shorthand, calculator dexterity, blueprint reading, plumbing, electrical, carpentry, other)?
______
REFERENCES
List the names of three (3) persons (not related to you) that you have known for at least three years.
1. Name and Address______Phone #______
Type of Association ______Years Known______
- 2.Name and Address ______Phone #______
Type of Association ______Years Known______
- 3.Name and Address ______Phone #______
Type of Association ______Years Known ______
Additional information may be submitted on separate sheet.
Resume may be submitted at time of interview.
(Additional Questions on Back)
“PLEASE PRINT OR TYPE”
EMPLOYMENT RECORD
Please list current (or most recent) employment first
Name /Address of Employer______
Supervisor______Dates From ______To______
Begin Salary ______Ending ______Reason for leaving______
Describe the work you did: ______
Name/Address of Employer______
Supervisor______Dates From ______To______
Begin Salary ______Ending ______Reason for leaving______
Describe the work you did: ______
Name/Address of Employer______
Supervisor______Dates From ______To______
Begin Salary ______Ending ______Reason for leaving______
Describe the work you did: ______
May we contact each employer listed above to obtain work references? _____Yes _____No
CRIMINAL RECORD
Have you ever been convicted of a felony, pled guilty or “no contest” to a felony charge?Yes______No______
If yes, what crime and when?______
Please explain:______
If employed you will be required to have a fingerprint check by FBI and FDLE.
PHYSICAL ABILITY
The position(s) for which you are applying my require the following job related, but not limited to, physical functions: standing, climbing, walking, use of both hands, bending, lifting, speaking, hearing, adequate eye vision, operating equipment.
Are you able to perform all of the above job-related functions? ______
If no, please explain and state which you cannot perform: ______
______
List any additional information which might be helpful.
______
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for non-employment or dismissal from employment.
Signature of Applicant ______Date ______