Employment Application | Northland Public Library

Application for Employment

Instructions This application must be completed in its entirety. Please do not refresh your browser or your entries will be lost.

Position you are applying for
Job Type
Full TimePart TimeHourlyTemporary
Name (First, Last)
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone
Email

Are you at least 16 years old?
YesNo
Do you have the right to work in the United States?
YesNo
May we contact your current employer?
YesNo
If no, please indicate someone familiar with your work performance for your current employer that we may contact (name and phone number)
Can you work:
EveningsWeekends
Please check any current clearances that you have.
* All three are required upon offer of employment.PA CriminalPA Child AbuseFBI Criminal
Date of PA Criminal Clearance
Date of PA Child Abuse Clearance
Date of FBI Criminal Clearance

Education

Last High School Attended
Location
Highest Grade Completed (choose one)
9101112
Do you have a High School Diploma or G.E.D. Certificate?
YesNo
Secondary Education Please list colleges, universities, trade or technical schools or apprenticeship programs.
Name of institution
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Number of years/months attended
Degrees, credits, certificates or licenses

Name of institution
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Number of years/months attended
Degrees, credits, certificates or licenses

Name of institution
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Number of years/months attended
Degrees, credits, certificates or licenses

Other Qualifications

Instructions Not all positions at Northland Public Library require a high school or college degree. We are very interested in knowing what experience you have (either through work, volunteering, etc.) which is relevant to the position you're applying for. We encourage you to include that experience in the space(s) below.
List any trade, professional or skills certificates you hold.
Summarize special skills, abilities, or experience which qualify you for this position.

Background

Employment History

Employer
Job Title
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Dates employed (start, end)
Supervisor's name, email and phone
Reason for leaving

Employer
Job Title
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Dates employed (start/end)
Supervisor's name, email, and phone
Reason for leaving

Employer
Job Title
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Dates employed (start/end)
Supervisor's name, email and phone
Reason for leaving
Upload Resume
Upload Cover Letter

References

Name
Relationship
Phone
Email

Name
Relationship
Phone
Email

Name
Relationship
Phone
Email
Certification, Authorization and Agreement I certify that the information supplied by me on this application form and in my resume, if any, is true and complete and does not contain any falsifications, omissions or concealments of material fact. I authorize the Northland Public Library Authority to investigate the truth of this information and any other information I may supply during a pre-employment interview. I hereby release my former employers, all educational institutions and programs, and every other person identified by me on this form or in my resume from liability for any damage or injury to me arising out of the release of information requested by the Northland Public Library Authority. I understand and agree that the Northland Public Library Authority’s acceptance of this employment application does not constitute any promise, expressed or implied, that I will be hired. I further understand that the Northland Public Library Authority does not guarantee anyone employment for any specific length of time. I therefore agree that, if I am hired, my employment may be terminated by me or the Northland Public Library Authority at any time without notice or cause. I certify that I am not a party to any contract or other obligation which would limit, interfere with or restrict my ability to work for the Northland Public Library Authority in any way. By electronically submitting this employment application, By signing this employment application, I hereby acknowledge that I have read this section of the employment application and fully understand the meaning and effect of signing this form.
Signed
Date

Please type any two numbers.

Certification, Authorization, and Agreement *I certify that the information supplied by me on this application form and in my resume, if any, is true and complete and does not contain any falsifications, missions or concealment of material fact. I authorize the Northland Public Library Authority to investigate the truth of this information and any other information I may supply during a pre-employment interview.
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Application for Employment

Education

Other Qualifications

Background

Employment History

References

Please type any two numbers.

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