Application for Employment
Education Service Center Region 15
P O Box 5199 San Angelo, Texas 76902
POSITION(S) APPLYING FOR: ______NAME ______
Last First Middle
ADDRESS ______
Street City/State Zip Code
PHONE NO. ______ALTERNATE PHONE NO. ______
EMAIL______
EDUCATIONAL AND PROFESSIONAL PREPARATION
Name And Location Of Last High School Attended / Years Attended / GraduatedName of Technical Training Schools, Business Colleges, Colleges and/or Universities attended (List in order) / Years
Attended / Major / Minor / Degrees Earned / Certificates or Endorsements
PREVIOUS EXPERIENCE
Position / Employer / Address / Name ofImmediate Supervisor / Dates / Reason for Leaving
REFERENCES – Give at least five references. (Do not include relatives)
Name / Address
(Please give complete mailing address) / Phone No. / Occupation
(Please complete both sides/pages of the application)
FOR POSITIONS REQUIRING CERTIFICATION OR COLLEGE DEGREE:· Copies of college/university transcripts, certifications, and/or professional licenses must be submitted with the application.
· A letter that provides information regarding your reason for applying for the position as well as your experience and qualifications must accompany this application.
FOR POSITIONS REQUIRING CLERICAL/TECHNICAL SKILLS:
SKILL AREAS OF COMPETENCY
(Complete only if applicable for position desired)List equipment you operate (computer, calculator, scanner, etc.) ______
______
______
Software Applications ______
______
Bookkeeping ______
Typing Speed ______
FOR ALL POSITIONS
· All persons are employed subject to funding.
· Employment is contingent upon acceptable criminal history check.
· All qualified applicants will be notified by mail of decisions made regarding their application.
· Education Service Center Region 15 will retain applications on file for two years unless otherwise instructed.
“AN EQUAL OPPORTUNITY EMPLOYER”
The above are true and accurate statements. I agree that any purposeful omission or false statements will constitute grounds for immediate dismissal. I also understand that this application will not be considered unless it is completed in detail and information requested is forwarded to Education Service Center Region 15.______
Signature of Applicant Date
Return to: Education Service Center Region 15 Attn: Personnel
Mail: PO Box 5199 San Angelo, TX 76902 or Fax: 325-655-4823
FOR ESC 15 USE ONLYTESTING ______INTERVIEW ______SALARY ______
Date/Time / Date/Time
Rev. 2/12