Job Application Form

Please Read Carefully

All requested information must be furnished. Fill in all spaces accurately and completely. If an item does not apply to you, or if there is no information to be given, write the letters “NA” for “not applicable.” All information contained in the application is subject to verification. Omissions or erroneous statements may be cause for rejection of this application, removal from employment eligibility, or discharge from the library.

Equal Opportunity Employer

Jefferson County Library is an Equal Opportunity Employer and does not discriminate on the basis of age, ancestry, race, religion, color, sex, national origin, citizenship, marital status, disability, arrest and court record, sexual orientation, or other grounds protected under local, state, and federal laws, except where a bona fide occupational qualification exists.

For which position are you applying?

Personal Information

Have you ever served in the Armed Forces?

Can you perform the essential functions of the position you are applying for, with or without reasonable accommodation?

If hired, can you furnish proof that you are legally entitled to work in the U.S.?

Education

School Attended Year Graduated Course of Study or Major Type of Certification or Degree
more items

Employment History

Employer Position Name of Supervisor Phone Number Employment Dates Reason for Leaving
(mm/yyyy to mm/yyyy)
more items

References

First and Last Name Phone Number City, State
more items
Upload your cover letter in .pdf, .doc or .docx format. Use the following format to name your document: FirstName-LastName-Coverletter.
One file only.
25 MB limit.
Allowed types: pdf, doc, docx.
Upload your resume in .pdf, .doc or .docx format. Use the following format to name your document: FirstName-LastName-Resume
One file only.
25 MB limit.
Allowed types: pdf, doc, docx.

Please read carefully before signing.

  • By submitting this application, I promise that the information provided in this employment application (and accompanying resume or documentation) is true and complete, and that any false or misleading information or omissions may disqualify me from further consideration for employment and may lead to my immediate discharge from employment if discovered at a later date.
  • I authorize the Library to fully investigate my personal and employment history and authorize all of the employers (person, firm or corporation), personal references, school, government agency and any other entity to provide the Library with any information, including fact or opinion that they may have regarding me. I release the Library and all providers of any information from liability as the result of furnishing and receiving this information. I understand and agree that if offered employment, any such employment offer shall be dependent upon the receipt of satisfactory references as determined by Jefferson County Library.
  • I authorize the Library to provide truthful information regarding my employment to any potential or future employer and release and waive any claims against the Library for truthfully communicating any such information to a potential or future employer.
  • I understand that this application does not create a contract of employment, and that, if hired, I am obligated to comply with any and all current and subsequently adopted Library policies.
  • I understand that the Library has the right to modify, amend, or terminate policies, benefit plans, and other Library programs within the limits and requirements imposed by law.
  • I understand that if hired, I will be required to abide by all rules and Library policies. I also understand that my employment at Jefferson County Library is at-will and may be discontinued by either the Library or myself at any time, with or without cause, for any or no reason. The Library Director has sole authority to change the at-will policy and/or create an employment contract.

Applicant Signature

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.