APPLICATION FOR NON-CERTIFIED PERSONNEL
APPLICATION FOR NON-CERTIFIED PERSONNEL
The Wall School District 51-5 does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities. An equal opportunity employer.
Wall School District 51-5 (Please type or use black ink.)
P.O. Box 414
Wall, SD 57790-0414 Date: ______________________
Phone: (605) 279-2156
I. PERSONAL DATA
Name of Applicant _____________________________________________________________________________
(Last) (First) (Middle)
Present Address _______________________________________________________________________________
(Street) (City) (State) (Zip)
Social Security Number _______________________________ Telephone ________________________________
Do you have duties that would interfere with your acceptance of any assignment for the good of the system, or attending meetings or participating in other activities outside of the work hours, which are related to the general school program?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Have you ever been employed by the Wall School District? ________________________When? ______________________
Have you ever been convicted of a felony or any offense involving moral turpitude?* _______________________________
If yes, please explain: __________________________________________________________________________________
____________________________________________________________________________________________________
*A conviction will not necessarily be a bar to employment. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into consideration.
Have you previously filed an application with the Wall School District? __________________________________________
If so, give the date: ____________________________________________________________________________________
II. EMPLOYMENT DATA
What type of work are you applying for (be specific)? _________________________________________________________
Salary Desired? ______________________ Will you accept temporary employment? _______________________________
When could you begin work? ____________________________________________________________________________
Previous Work Experience – begin with most recent
Employer Telephone Assignment Dates From – To
____________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
In what line of work are you experienced or do you have particular training?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
List any experience you have operating machines or equipment. (Examples: Secretary-computer, copy machines; Custodian-floor scrubbers, etc.; Cook-mixers, big ovens, etc.; Teacher Aide-computers, copy machines, A.V. equipment.)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What is the highest grade or degree of education completed? __________________________________________________
List any specialized education or training
Name & Location of School Years attended Course Pursued Degree Date
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
III. REFERENCES
Name Position Complete Mailing Address Telephone
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
___________________________________________________
Applicant’s Official Signature
__________________________________
Date
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