Application for Employment Instructions:
No walk-ins or phone applications will be accepted. Potential candidates for any jobs will receive a phone call or letter regarding their status after all applications are received.
Copy and paste the application below into your word processing software. Fill it out and mail it to the Breckenridge Library Board, 209 N. Breckenridge Ave., Breckenridge, TX 76424. Be sure to attach a copy of your resume to the application before mailing the application. All applications are confidential and are kept on file for six months.
You may also access a printable .PDF version of the employment application by using the button below. You will need to have the free Adobe Reader program installed on your computer in order to open and print the application. You will not be able to type directly into this document, but the application can be neatly hand-written.
No walk-ins or phone applications will be accepted. Potential candidates for any jobs will receive a phone call or letter regarding their status after all applications are received.
Copy and paste the application below into your word processing software. Fill it out and mail it to the Breckenridge Library Board, 209 N. Breckenridge Ave., Breckenridge, TX 76424. Be sure to attach a copy of your resume to the application before mailing the application. All applications are confidential and are kept on file for six months.
You may also access a printable .PDF version of the employment application by using the button below. You will need to have the free Adobe Reader program installed on your computer in order to open and print the application. You will not be able to type directly into this document, but the application can be neatly hand-written.
BRECKENRIDGE LIBRARY APPLICATION FOR EMPLOYMENT
INSTRUCTIONS: Print in black ink or type all information. Fill out the form completely. If questions are not applicable, enter “NA”. Do not leave any questions blank. Be sure to sign the form when completed. The Breckenridge Library is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. Resumes will not be accepted in lieu of applications, unless specifically stated in the job vacancy notice. This application becomes pubic record and is subject to disclosure and may be reviewed by the Breckenridge Library Board and the Breckenridge Library and Fine Arts Foundation Board.
Name ___________________________________________ Social Security No. _____-_______-_______
Mailing Address ________________________________________________________________________
Cell Number (____) _______________________ Home Number (____) _________________________
E-mail Address _________________________________________________________________________
Current Driver’s License No. ______________________________________________________________
(Some driving may be required)
Check the type of work for which you are applying:
_____ Director
_____ Assistant Librarian
_____ Custodian
_____ Adult Volunteer (Over 18) Paid _____ Unpaid _____
Do you have any relatives working for the library? ______ Yes _____ No
Do you have any relatives serving on the Library Board or on the Library Foundation Board? ____ Yes ___ No
What days are you unable to work? _________________________________________________________
Have you ever been convicted of a felony or subjected to a deferred adjudication on a felony charge?
____ Yes ____ No
If the answer is “yes”, explain in concise detail on a separate sheet of paper, giving the dates and nature of the offense, the name and location of the court, and the disposition of the case(s). A conviction may not disqualify you, but a false statement will. The Breckenridge Library performs back ground checks on all employees and volunteers and may require drug testing.
EDUCATION (Note: Applicants may be required to provide proof of diploma, degree, transcripts, licenses, certifications, and registrations.)
Indicate Highest Grade Completed: 1 2 3 4 5 6 7 8 9 10 11 12
Did you graduate from high school or receive GED? ____ Yes ____ No
Name and Location of School _____________________________________________________________
Dates Attended ____________________ Date Graduated _______ Semester Hours Completed _________
Type of Diploma or Degree ________________________________________________________________
Major/Minor Fields of Study ________________________________________________________________
Name and Location of School ______________________________________________________________
Dates Attended ____________________ Date Graduated _______ Semester Hours Completed __________
Type of Diploma or Degree _________________________________________________________________
Major/Minor Fields of Study _________________________________________________________________
Name and Location of School _______________________________________________________________
Dates Attended ____________________ Date Graduated _________ Semester Hours Completed _________
Type of Diploma or Degree __________________________________________________________________
Major/Minor Fields of Study _________________________________________________________________
COMPUTER SKILLS:
____ Yes, I have computer skills. ____ No, I do not have computer skills. If Yes, describe your skills below.
Approximately how many words per minute do you type? ____________
Do you have an email address? ____ Yes ____ No
Check the software below that you can use with proficiency.
___ WordPerfect _____ Microsoft Word ____ Microsoft Works
___ Quatro Pro _____ Excel ____ Quickbooks
___ Microsoft Access _____ Outlook/ Outlook Express ____ First Publisher
___ Adobe Acrobat _____ Printshop ____ Front Page
___ Other: describe _________________________________________________________________
_____________________________________________________________________________________
SPECIAL SKILLS:
Sign language ____ Yes ____ No Are you a certified interpreter? ____ Yes ____ No
Spanish ____ Yes ____ No Read it? _____ Write it? _____ Speak it? _____
Other languages (be specific) _______________________________________________________________
EMPLOYMENT HISTORY: (Start with present or last position) Attach extra pages if necessary.
Employer: _______________________________________________________________________________
Complete Address: ________________________________________________________________________
Supervisor: __________________________________________________ Phone: ______________________
Position Title: _____________________________ From __________________ To ______________________
Duties: __________________________________________________________________________________
Salary: Beginning _____________________________ Last ________________________________________
Reason for leaving: ________________________________________________________________________
Employer: _______________________________________________________________________________
Complete Address: ________________________________________________________________________
Supervisor: __________________________________________________ Phone: ______________________
Position Title: ______________________________ From ______________________ To _________________
Duties: __________________________________________________________________________________
Salary: Beginning _______________________________Last ______________________________________
Reason for leaving: _______________________________________________________________________
Employer: _______________________________________________________________________________
Complete Address: ________________________________________________________________________
Supervisor: ______________________________________________________ Phone: __________________
Position Title: ___________________________________ From ___________________ To _______________
Duties: __________________________________________________________________________________
Salary: Beginning ________________________________ Last _____________________________________
Reason for leaving: _______________________________________________________________________
Employer: _______________________________________________________________________________
Complete Address: ________________________________________________________________________
Supervisor: _____________________________________________________ Phone: ___________________
Position Title: ___________________________________ From ___________________ To _______________
Duties: __________________________________________________________________________________
Salary: Beginning ________________________________ Last _____________________________________
Reason for leaving:_ _______________________________________________________________________
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND INDICATE YOUR
UNDERSTANDING AND ACCEPTANCE BY SIGNING IN THE SPACE PROVIDED.
THIS APPLICATION MUST BE SIGNED (Sign Here)
__________________________________________________________________________________________________
Signature — Applicant Date ________________________________________
INSTRUCTIONS: Print in black ink or type all information. Fill out the form completely. If questions are not applicable, enter “NA”. Do not leave any questions blank. Be sure to sign the form when completed. The Breckenridge Library is an equal opportunity employer and does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. Resumes will not be accepted in lieu of applications, unless specifically stated in the job vacancy notice. This application becomes pubic record and is subject to disclosure and may be reviewed by the Breckenridge Library Board and the Breckenridge Library and Fine Arts Foundation Board.
Name ___________________________________________ Social Security No. _____-_______-_______
Mailing Address ________________________________________________________________________
Cell Number (____) _______________________ Home Number (____) _________________________
E-mail Address _________________________________________________________________________
Current Driver’s License No. ______________________________________________________________
(Some driving may be required)
Check the type of work for which you are applying:
_____ Director
_____ Assistant Librarian
_____ Custodian
_____ Adult Volunteer (Over 18) Paid _____ Unpaid _____
Do you have any relatives working for the library? ______ Yes _____ No
Do you have any relatives serving on the Library Board or on the Library Foundation Board? ____ Yes ___ No
What days are you unable to work? _________________________________________________________
Have you ever been convicted of a felony or subjected to a deferred adjudication on a felony charge?
____ Yes ____ No
If the answer is “yes”, explain in concise detail on a separate sheet of paper, giving the dates and nature of the offense, the name and location of the court, and the disposition of the case(s). A conviction may not disqualify you, but a false statement will. The Breckenridge Library performs back ground checks on all employees and volunteers and may require drug testing.
EDUCATION (Note: Applicants may be required to provide proof of diploma, degree, transcripts, licenses, certifications, and registrations.)
Indicate Highest Grade Completed: 1 2 3 4 5 6 7 8 9 10 11 12
Did you graduate from high school or receive GED? ____ Yes ____ No
Name and Location of School _____________________________________________________________
Dates Attended ____________________ Date Graduated _______ Semester Hours Completed _________
Type of Diploma or Degree ________________________________________________________________
Major/Minor Fields of Study ________________________________________________________________
Name and Location of School ______________________________________________________________
Dates Attended ____________________ Date Graduated _______ Semester Hours Completed __________
Type of Diploma or Degree _________________________________________________________________
Major/Minor Fields of Study _________________________________________________________________
Name and Location of School _______________________________________________________________
Dates Attended ____________________ Date Graduated _________ Semester Hours Completed _________
Type of Diploma or Degree __________________________________________________________________
Major/Minor Fields of Study _________________________________________________________________
COMPUTER SKILLS:
____ Yes, I have computer skills. ____ No, I do not have computer skills. If Yes, describe your skills below.
Approximately how many words per minute do you type? ____________
Do you have an email address? ____ Yes ____ No
Check the software below that you can use with proficiency.
___ WordPerfect _____ Microsoft Word ____ Microsoft Works
___ Quatro Pro _____ Excel ____ Quickbooks
___ Microsoft Access _____ Outlook/ Outlook Express ____ First Publisher
___ Adobe Acrobat _____ Printshop ____ Front Page
___ Other: describe _________________________________________________________________
_____________________________________________________________________________________
SPECIAL SKILLS:
Sign language ____ Yes ____ No Are you a certified interpreter? ____ Yes ____ No
Spanish ____ Yes ____ No Read it? _____ Write it? _____ Speak it? _____
Other languages (be specific) _______________________________________________________________
EMPLOYMENT HISTORY: (Start with present or last position) Attach extra pages if necessary.
Employer: _______________________________________________________________________________
Complete Address: ________________________________________________________________________
Supervisor: __________________________________________________ Phone: ______________________
Position Title: _____________________________ From __________________ To ______________________
Duties: __________________________________________________________________________________
Salary: Beginning _____________________________ Last ________________________________________
Reason for leaving: ________________________________________________________________________
Employer: _______________________________________________________________________________
Complete Address: ________________________________________________________________________
Supervisor: __________________________________________________ Phone: ______________________
Position Title: ______________________________ From ______________________ To _________________
Duties: __________________________________________________________________________________
Salary: Beginning _______________________________Last ______________________________________
Reason for leaving: _______________________________________________________________________
Employer: _______________________________________________________________________________
Complete Address: ________________________________________________________________________
Supervisor: ______________________________________________________ Phone: __________________
Position Title: ___________________________________ From ___________________ To _______________
Duties: __________________________________________________________________________________
Salary: Beginning ________________________________ Last _____________________________________
Reason for leaving: _______________________________________________________________________
Employer: _______________________________________________________________________________
Complete Address: ________________________________________________________________________
Supervisor: _____________________________________________________ Phone: ___________________
Position Title: ___________________________________ From ___________________ To _______________
Duties: __________________________________________________________________________________
Salary: Beginning ________________________________ Last _____________________________________
Reason for leaving:_ _______________________________________________________________________
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND INDICATE YOUR
UNDERSTANDING AND ACCEPTANCE BY SIGNING IN THE SPACE PROVIDED.
- I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to hire or, if hired, termination.
- I understand that as a condition of employment, I may be required to provide legal proof of authorization to work in the U.S.
- I understand that the Library may check with the Texas Department of Public Safety, the Federal Bureau of Investigation or other organizations, for any criminal history in accordance with applicable statues and a drug test may be requested.
- I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you.
- I understand that disclosure of my Social Security Number (SSN) is optional, unless I am hired. The Library may use the SSN for payroll purposes and/or for identification of individuals employed. Volunteers do not need to disclose their SSN for any reason. This is in accordance with the Federal Law U.S.C. 552a Section 7(b).
THIS APPLICATION MUST BE SIGNED (Sign Here)
__________________________________________________________________________________________________
Signature — Applicant Date ________________________________________
