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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.
Employment Application

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.




  1. 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.
  2. I understand that as a condition of employment, I may be required to provide legal proof of authorization to work in the U.S.
  3. 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.
  4. 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.
  5. 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 ________________________________________




 

 






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