noncertifiedjobappform

NON-CERTIFIED JOB APPLICATION Minooka Community Consolidated School District #201 Online Application for Employment - Non-Certified Personnel Please fill in the application and submit via Email or print it, then mail the application to: Dr. Stephen Palaniuk, Assistant Superintendent, Minooka CCSD #201, 304 Mondamin St. - Suite 116, Minooka, IL 60447.
PERSONAL DATA:
Last Name First Name:	MI
Social Security Number
Present Address:
Number and Street
City	State Zip
Permanent Address:	Same as Above:
Number and Street
City	State Zip
Telephone(home)	Telephone(work)
Email address:

POSITION APPLIED FOR:	A separate application must be completedfor each position applied for below:
	Secretary Instructional Aide Bus Driver Cafeteria Worker Bookkeeper Playground Custodian Summer Employment Coach Please list sports:
Assignment Preferences:	Full Time Part Time
When are you available to begin employment?
	Current Salary: Expected Salary:
EDUCATION:
High School:
Dates Attended:
Diploma received?	Yes No
College/University:
Dates Attended:

Other:

CO-CURRICULAR ACTIVITIES: (List personal Interests and Hobbies)

OTHER EMPLOYMENT EXPERIENCE:
Note: Failure to provide requested employment or employer history which is material to the applicant's qualifications for employment or the provision of statements which the applicant does not believe to be true may be a Class A midemeanor.
1. Years (Dates):	Employer:
Address:	Position:
	Full Time: Part Time:

2. Years (Dates):	Employer:
Address:	Position:
	Full Time: Part Time:

3. Years (Dates):	Employer:
Address:	Position:
	Full Time: Part Time:

4. Years (Dates):	Employer:
Address:	Position:
	Full Time: Part Time:

5. Years (Dates):	Employer:
Address:	Position:
	Full Time: Part Time:

	During the past seven years, have you been convicted of a serious crime involving a person's life or property? Yes No

MILITARY SERVICE RECORD:	Branch of Service:
Date Entered:
Date Discharged:
Service-related Skills:

Community Activities:

Volunteer Activities:

REFERENCES:	Please list at least three current professional references.
Name:
Address:
Phone:
Name:
Address:
Phone:
Name:
Address:
Phone:
Name:
Address:
Phone:

Narrative: What special skills do you have that relate to the position for which you are applying? (carpentry, plumbing, sheet metal, baking, computer skills, keyboarding, etc.)
	Please read carefully before submitting:
Please print and mail this application along with a current resume. After submitting the application, be sure to click the Reset Form button to clear your information from the form. By submitting this application, you certifiy that the facts set forth in this application for employment are true, accurate, and complete. You understand that any misrepresentations or omissions of facts made by you on this application shall be sufficient cause for your disqualification for employment or termination of employment. Furthermore, you understand that, pursuant of Section 22-6.5 of The School Code, 105 ILCS 5/22-6.5, your failure to provide requested employment or employer history which is material to your qualification for employment or the provision of statements which you do not believe to be true may be a Class A misdemeanor. You understand this application and records become the property of Minooka Community Consolidated School District 201. You hereby authorize Minooka Community Consolidated School District 201 to conduct work and reference checks to determine your acceptability. Complete files are maintained for one year only. It is the applicant's responsibility to update his/her file by completing a new application for employment.
Signature of applicant:
	If submitting by mail, please send to Dr. Stephen Palaniuk, Minooka CCSD #201, 305 Church St., Minooka, IL 60447.


	Please reset the application after printing or saving.
Reset Application:

Minooka Community Consolidated School District #201 is an equal opportunity employer and does not discriminate on the basis of race, sex, color, national origin, ancestry, religion, age, physical or mental handicap or disability, marital status, military status, or unfavorable discharge from military service. This employer only hires individuals authorized to work under the Immigration Reform and Control Act of 1986.