Blooming Prairie Public Schools
Blooming Prairie Public Schools is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on the basis of race, color, creed, religion, national origin, age, sex, disability, marital status, or status with regard to public service.
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Date Available for Work
Position Desired
-- Intermediate/High School Night Custodian
Military Service: Are you a Veteran?
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Branch of Service
Type of Discharge
Community Work and Other Interests/Activities
EDUCATION
Highest Level of Education
High School
Trade, Business, or Other School
College
Graduate School
Subjects of Social Study or Research Work
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Employment History
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-- AL AK AZ AR CA CO CT DC DE FL GA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY
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-- AL AK AZ AR CA CO CT DC DE FL GA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY
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Supervisor's Name:
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-- AL AK AZ AR CA CO CT DC DE FL GA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY
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Supervisor's Name:
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-- AL AK AZ AR CA CO CT DC DE FL GA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY
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Supervisor's Name:
Reason You Left:
Description of Duties:
List any special skills/qualifications you possess which are directly related to the position for which you are applying (ie: Clerical, Typing, Machines/Equipment):
Are you employed now?
Yes
No
May we contact your present employer?
Yes
No
May we contact your past employers?
Yes
No
Comments:
List three persons not related to you who have known you for at least a year, preferably job related.
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-- AL AK AZ AR CA CO CT DC DE FL GA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY
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Years Known:
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-- AL AK AZ AR CA CO CT DC DE FL GA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY
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Years Known:
First Name:
Last Name:
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-- AL AK AZ AR CA CO CT DC DE FL GA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY
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Years Known:
By clicking yes, I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for refusal of employment or dismissal. I also understand that my employment is subject to the Blooming Prairie Publics School's personnel policies and procedures.
Yes
No
AFFIRMATIVE ACTION SURVEY
Applicants are considered for all positions, and employees are treated without regard to race, color, creed, religion, national origin, sex, disability, age, marital status, or status with regard to public assistance.
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Male
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Race/Ethnic Group - Check One of the Following:
Caucasian
Black
Hispanic
American Indian/Alaskan Native
Asian/Pacific Islander
Check if any of the following are applicable:
Vietnam Era Veteran
Disabled Veteran
Handicapped Individual
How did you learn about this position (check all that apply):
Posted Job Announcement at this Office
Friend or Relative
State Employment Office
Private Employment Agency
Rehire
Wanted Ad
Walk-in
Minnesota Fraud Statue: Any person who, with intent to defraud, receives workers' compensation benefits to which the person is not entitled by knowingly misrepresenting, misstating, or failing to disclose any material fact is guilty of theft and shall be sentenced pursuant to section 609.52, subdivision 3.
