Are you 18 years or older? * Street Address: * City: * State: * Zip Code: * Phone Number: * Type of position desired: * What type of employment are you seeking? * Salary or Wage expected: * Are you legally eligible for employment in the United States? * Are you currently employed? * May we contact your current employer? * May we contact YOU at your current employment? * Are you currently on "lay-off" status and subject to recall? * If you answered yes to the above question, please explain: When can you begin work? * Are you available to work a varied schedule, including evenings until 7 PM and Saturdays, as needed? * do you have a valid drivers license and access to reliable transportation? * How did you learn of Adams County Public Library? * Are you related to anyone employed at Adams County Public Library? If yes, list names and relation: * Have you ever been bonded? If yes, list employer name, address, and telephone number: * Have you ever applied for employment with the library? If yes, list month and year: * Employment History *
Please list your employment history. List your most recent employer first, and include the following: Company Contact Information, Name and Title of Supervisor, Job Title and Description of Major Responsibilities, Dates Employed, Annual Pay, and Reason for Leaving.
Have you served in the military? * If you answered yes to the above question, please list branch and dates served: Education and Training *
Please list your education and training history. Include: School Contact Information, Years Completed, Diploma/Degree, Course of Study, and Any Honors Received.
Special Training or Skills * References *
Please list professional references. Include: Name, Contact Information, Relationship, and Years Known.
APPLICANT'S AGREEMENT I understand and agree that, if I am employed by the Adams County Public Library, my employment is entirely "at will," which means that my employment is not guaranteed for any definite period of time, and that my employment can be modified or terminated, with or without cause, and regardless of the date of payment of my wages and salary, and with or without prior notice at any time, at the option of either the Adams County Public Library or myself. I understand and agree that the Adams County Public Library reserves the right to establish and/or change any of the terms or conditions of any aspect of my employment, including my compensation, at its discretion at any time with or without notice. I understand and agree that no other oral or written agreements or promises of any kind pertaining to the terms of my employment and/or my compensation exist outside of this Agreement, and if I believe that any such previous agreements or promises between any Adams County Public Library representative and myself have been made, I agree they are superseded by the contents of this Agreement. I understand and agree that no representative of the Adams County Public Library, other than the President of the Board, acting on behalf of the Board of Trustees, has any authority to enter into any other agreement with me or provide me with any assurances relating to any aspect of my employment with the Adams County Public Library, except that the above mentioned official of the Adams County Public Library may do so in writing, although the terms of that agreement cannot contradict the contents of this Agreement. The terms of this Agreement will supersede all others. I understand that if I am offered employment by the Adams County Public Library, and if I accept that offer, this document will serve as the only agreement between the Adams County Public Library, its representatives and myself. I also agree that $1.00 of the wages that I am paid when I report to work on my first day of employment will serve as sufficient consideration to bind this Agreement. I authorize the Adams County Public Library to investigate my background, qualifications and/or any other information from whomever it deems appropriate. I also authorize anyone that the Adams County Public Library contacts as part of its investigation to release any information they have regarding me or my employment to the Adams County Public Library or its representatives. I also release all parties from all liability for any damage that may result from furnishing this information to the Adams County Public Library. Further, I release the Adams County Public Library from all liability for any information it might deem appropriate to release regarding me and my employment in the future. I further agree to take any lawful medical examination, chemical, drug or alcohol test upon request by the Adams County Public Library at its sole discretion as a condition of my employment, or, if I am hired, as a condition of my continued employment at any time as deemed appropriate by the Adams County Public Library. I agree that my refusal to take any such examinations or tests immediately upon request may be cause for my not being hired or, if I am hired, may be cause for the immediate termination of my employment. I hereby release all persons or companies conducting such examinations from all liability. I also certify that the facts contained in this application are true and complete to the best of my knowledge and understanding that if I am employed, any statements that I have falsified on this application shall be grounds for dismissal. I further certify that I have read all of the foregoing, understand the same and do hereby voluntarily agree to all of the provisions contained herein. * READ CAREFULLY BEFORE SIGNING I agree that any claim or lawsuit relating to my service with the Adams County Public Library or any of its subsidiaries must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary. I understand that if I am hired, this employment application will become part of my official employment record. *