City State - None -Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Marianas Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip Do you have any commitments that might interfere with your employment? - None -Yes No Are you related to anyone employed by Puskarich Public Library? - None -Yes No If yes, please explain Have you ever been dismissed from or asked to resign from any employment position? - None -Yes No Name and relationship Name of college or university Type of degree: Monday-Friday availability - None -Mornings Afternoons Evenings None Saturday availability - None -Mornings Afternoons Evenings None Did you graduate? - None -Yes No Place of Employment: Current employment? - None -Yes No Address Current/final salary Job duties Position(s) held Full name and title of supervisor May we contact your current employer for a reference? - None -Yes No Name of high school Dates employed--from: Did you graduate from high school? - None -Yes No Dates employed--to Do you wish to leave your current employer? - None -Yes No 2. Name If yes, why? 3. Name Email (if known) 1. Name First name Middle name Last name Street address Email address ARE YOU LEGALLY PERMITTED TO WORK IN THE UNITED STATES? - None -Yes No ARE YOU SIXTEEN (16) YEARS OR OLDER? - None -Yes No Position desired Full time or part time? - None -Part time Full time Date available to start Why are you interested in working for Puskarich Public Library? Other than English, are you fluent in any language? - None -Yes No If so, please list In which computer programs do you feel you have proficiency? - None -Microsoft Word Microsoft Excel Microsoft Publisher Searching online Other If you checked other, please list: Do you have any other advanced training, continuing education or life experience that you think would be helpful in the position for which you are applying? - None -Yes No If yes, please list: Signature Submit Book traversal links for Puskarich Public Library Job Application ‹ Job Opportunities Up Print
