Teton County Library | Jackson Hole Wyoming

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Teton County, Jackson, Wyoming
(An Equal Opportunity Employer)
Job Application Form

Note: This is not a secure server site. Items marked with an asterisk * are required. You may omit your SSN and any other data that you deem sensitive from the online form and submit this in person or via fax.

Date
* Type of position desired
Personal Information
* Full Name
* Phone Number
* Address
* City-State-Zip Code
Message Phone  
Full Name
City-State-Zip Code
Phone Number
* E-mail

Educational Background

TYPE OF
SCHOOL 		  School Name,
City and State where located 		  Last
Year
Completed 		  Did You
Graduate? 		  Major Course of Study
and Degree Granted
High
School 		      1
2
3
4 		  No
Yes 		   
College
or
Technical
School 		      1
2
3
4 		  No
Yes 		   
Post
Graduate
Courses 		      1
2
3
4 		  No
Yes 		   

Related Career Education
(Additional courses, trade schools, seminars, etc.) Briefly describe courses, length of program and when completed.

Previous Employment
(List most recent position first)
Name of Employer
(Company or Firm)
Phone Number
Complete Address
Date Hired Date Terminated
Final Salary $ Hourly Bimonthly Monthly Yearly
Position Title
Description of Duties
Reason for Leaving
   

Previous Position

  
Name of Employer
(Company or Firm)
Phone Number
Complete Address
Date Hired Date Terminated
Final Salary $ Hourly Bimonthly Monthly Yearly
Position Title
Description of Duties
Reason for Leaving
   

Previous Position

  
Name of Employer
(Company or Firm)
Phone Number
Complete Address
Date Hired Date Terminated
Final Salary $ Hourly Bimonthly Monthly Yearly
Position Title
Description of Duties
Reason for Leaving
   

Placement Information

  
Type of position desired
Salary expected to start $ per Hour Month Year
Earliest date available
Status Desired Full Time Part Time Either
Related Technical Skills
(list only skills or licenses pertinent to position applying for).

Employment References
List three previous supervisors or coworkers whom we can immediately contact:

First Reference

  
Name
Phone
Relationship to you
Current Company Name
City, State

Second Reference

  
Name
Phone
Relationship to you
Current Company Name
City, State

Third Reference

  
Name
Phone
Relationship to you
Current Company Name
City, State

General Information
Please describe the skills and aptitudes that you feel qualify you for a position with us. (You may wish to include activities and positions held in civic, community and school organizations, professional societies, special training and skills.) Do not list activities or groups that have restrictive membership status.
Have you ever been convicted of any offense involving dishonesty or breach of trust (including but not limited to embezzlement, forgery, perjury, robbery, tax evasion, theft, etc.)? A Yes answer does not necessarily disqualify you from consideration.
Yes No
If Yes, please explain:

The information provided on this application is accurate to the best of my knowledge and subject to verification. I understand that proof of U.S. permanent residency or authorization to work in the U.S. may be required upon employment. I understand that I must answer truthfully all the questions on this application. I also understand that if I do not, I may be refused employment or separated if I am a current employee.

If employment results from this application, I understand that additional personal data will be required to determine if I am eligible for benefits and for statistical/government reporting purposes.

Teton County Library reserves the right to require a criminal background check on any applicant. I understand and acknowledge that prior to and/or during employment, I may be required to submit to medical testing for alcohol and/or illicit and/or controlled substances, and I hereby consent to such testing.

I authorize all previous employers and listed references to furnish whatever information they may have regarding my employment and my reason for leaving. And I release my prior employers from all liability for any damage resulting from the information they provided.

I understand that employment with Teton County is at will and the employment relationship may be ended at any time by either party with or without notice.
Please review your application carefully. When complete click the send button below. When an online confirmation page is presented, print out a copy, sign, and present at the time of your interview.

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Copyright © 2008 Teton County Library
Last updated Wednesday, June 13, 2007 14:01 PM