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Custodian / Maintenance Application for Employment

THE MONROE COUNTY BOARD OF EDUCATION PROVIDES EQUAL OPPORTUNITIES TO ALL PERSONS REGARDLESS OF AGE, RACE, COLOR, CREED, DISABILITY OR GENDER IN ALL EDUCATIONAL AND EMPLOYMENT PRACTICES WITH THE INTENT OF COMPLYING WITH VARIOUS ANTI-DISCRIMINATION LAWS TO THE EXTENT APPLICABLE, INCLUDING BUT NOT LIMITED TO TITLE IX OF THE EDUCATION AMENDMENTS OF 1972, AS AMENDED; SECTION 504 OF THE REHABILITATION ACT OF 1973, AS AMENDED; THE AMERICANS WITH DISABILITIES ACT AS AMENDED; THE INTERNAL REVENUE CODE; TITLE VI, VII OF THE CIVIL RIGHTS ACT OF 1964, AS AMENDED; AND OTHER APPLICABLE ENACTMENTS OR REGULATIONS.

Position Applied For:*

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For what schools are you applying?*

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Any available

Other:

PERSONAL INFORMATION

First Name*

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Last Name*

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Middle Name*

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Maiden Name

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Email Address*

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Address (Street, R.F.D., Box No.)*

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City*

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County*

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Zip/Postal*

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Phone Number*

Number Required

Mobile Phone

Number Required

Have you ever been convicted of a felony or misdemeanor? If yes, please describe.*

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EDUCATION

School Attended, Enrollment or Graduation Date, Diploma or Degree, & Major Courses*

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School Attended, Enrollment or Graduation Date, Diploma or Degree, & Major Courses

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School Attended, Enrollment or Graduation Date, Diploma or Degree, & Major Courses

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WORK EXPERIENCE

Employer, Date Employed, Supervisor, & Duties*

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Employer, Date Employed, Supervisor, & Duties

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Employer, Date Employed, Supervisor, & Duties

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Describe any experiences, skills, or qualifications that you feel would especially benefit you for work as a custodian/maintenance employee.*

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REFERENCES

Name, Phone Number, Address, Title or Position*

Answer Required

Name, Phone Number, Address, Title or Position*

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Name, Phone Number, Address, Title or Position*

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Knowingly falsifying information required by TCA 49-5-406 subdivision (a)(1) shall be sufficient grounds for termination of employment and shall also constitute a Class A misdemeanor which must be reported to the district attorney general for prosecution. Accuracy of such information may be verified by fingerprint and criminal history records check conducted by the TBI pursuant to § 49-5-413 (a).

All persons hired for positions are required to meet all assigned duties, commitments and responsibilities of the position. I hereby certify that information given on this application is correct.

I understand that deliberate misrepresentation may result in my application not being considered or my position being terminated if I am employed. I further give permission to check all work and personal references listed herein and understand that I will not have access to information obtained from them.

NOTE: All applications must be updated annually. All questions must be answered and all blanks must be completed.

Signature of Applicant

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Date of Application

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Cover Letter and Resume (Optional)

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Confirmation Email

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