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 / Graduated
Name 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 of
Immediate 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 ONLY
TESTING ______INTERVIEW ______SALARY ______
Date/Time / Date/Time

Rev. 2/12