Application for Employment

Application for Employment

Westbrook Walnut Grove Public School ISD #2898 344 8th Street, PO Box 129 - Westbrook, MN 56183 WWG Schools 507-274-6111
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Are you 18 years or older?*

YesNo
Are you a Veteran?*

YesNo
Are you the spouse of a deceased or disabled Veteran?*

YesNo
Position*
Location Desired (choose all that apply)*

WWG Elementary-Walnut GroveWWG High School-WestbrookLittle Chargers Daycare-Westbrook
Are you presently employed?*

YesNo
May we inquire of your present employer?

YesNo
May we contact you at work?

YesNo
Work Telephone #
Please enter a valid phone number.
Education*
Have you ever been convicted of any crime other than a minor traffic violation? (**Conviction of a crime is NOT an automatic bar to employment. The district will consider the nature of theoffense, the date of the offense, and the relationship between the offense and the position for which you areapplying.)*

YesNo
What is the disposition of the case?
Special Qualifications (list below) (licenses, languages, machine operation, etc.):
What other education of training have you had that might relate to the position you are applying for?
Employment History: List complete employment history. Start with your present or most recent position first,then list the positions prior to that, etc. You do not need to provide dates of employment or jobs held more than 5 years ago*
References: Give the names of three persons not related to you, whom you have known at least one year*
You may upload your resume, cover letter, and any additional documents you’d like us to review

Cancelof
“I certify that the facts contained in this application form are true and complete to the best of my knowledge and
understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize
investigation of all statements contained herein and the references listed above to give you any and all
information concerning my previous employment and any pertinent information then may have, personal or
otherwise, and release all parties from all liability for any damage that may result from furnishing the same to
you. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the
date of payment of my wages and salary, be terminated at any time without prior notice.”
Signature

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Date

MonthDayYear
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AN EQUAL OPPORTUNITY EMPLOYER INDEPENDENT SCHOOL DISTRICT #2898
Certification, Acknowledgement and Release

I certify that the answers I have given on this application are true and correct to the best of my
knowledge. I understand that any false or misleading information provided or any omission or
concealment of facts will disqualify me from consideration for employment and constitutes grounds for
my immediate dismissal should I be employed by District #2898.

I understand, acknowledge and agree that no offer of employment is valid or binding until formal
approval by the School Board or the appointing authority referenced in the job description and that
until such approval that District #2898 shall not be liable for any reliance on any oral or written offers
of employment made to me.

In connection with this application, I hereby authorize any and all current and former employers,
organizations where I have volunteered, references named in this application, and any agent of a
former employer or volunteer organization to release to District #2898 and its agents any and all
information regarding my job performance, fitness/qualifications to perform the position I am presently
seeking and any other employment or related information both public and private, in their possession.
I understand that District #2898 will use this information to determine my fitness/qualifications for the
position I am seeking. This authorization expires one year from the date of my signature below.

I hereby release District #2898 and all former employers, volunteer organizations and references
listed herein and any and all agents acting on behalf of said District, former employers, volunteer
organizations or references, for any and all liability of whatever nature by reason of requesting or
providing such information.
Signature

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Date

MonthDayYear
Date
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