Employment

Position desired*

Page (PT)

Name*

First Middle Last

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone

Work/Other Phone

Email*

Social Security #*

Required for background check.

Driver's License #*

Required for background check.

Driver's License State of Issue*

State

Have you previously applied for employment with VHLF?*

Yes
No

If yes, month and year:

Have you ever been employed with VHLF?*

Yes
No

If yes, month and year employment began:

Are you currently employed?*

Yes
No

Hours available to work:*

Full-time
Part-time
Temporary

Date available to begin work:*

Are you legally eligible for employment in the United States?*

Yes
No

Education

High School Name & Location (city, state):

High School Course of Study:

Years Completed:

Freshman
Sophomore
Junior
Graduate

High School Diploma/Degree Earned:

College (Undergraduate) Name & Location (city, state):

College (Undergraduate) Course of Study:

Years Completed:

Freshman
Sophomore
Junior
Graduate

College (Undergraduate) Diploma/Degree Earned:

College (Graduate) Name & Location (city, state):

College (Graduate) Course of Study:

Years Completed:

Freshman
Sophomore
Junior
Graduate

College (Graduate) Diploma/Degree Earned:

Other Name & Location (city, state):

Other Course of Study:

Other Completed:

Freshman
Sophomore
Junior
Graduate

Other Diploma/Degree Earned:

Previous Employment

Begin with current/most recent employer. Complete this section in addition to uploading resume.

Upload resume, if available.

01. Employer's Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Position/Job Title

Dates Employed

Reason for Leaving

Job Duties & Responsibilities

Hourly Rate/Salary

Supervisor's Name & Contact Information (phone or email)

May we contact supervisor?

Yes
No

02. Employer's Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Position/Job Title

Dates Employed

Reason for Leaving

Job Duties & Responsibilities

Hourly Rate/Salary

Supervisor's Name & Contact Information (phone or email)

May we contact supervisor?

Yes
No

03. Employer's Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Position/Job Title

Dates Employed

Reason for Leaving

Job Duties & Responsibilities

Hourly Rate/Salary

Supervisor's Name & Contact Information (phone or email)

May we contact supervisor?

Yes
No

04. Employer's Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Position/Job Title

Dates Employed

Reason for Leaving

Job Duties & Responsibilities

Hourly Rate/Salary

Supervisor's Name & Contact Information (phone or email)

May we contact supervisor?

Yes
No

References

List any references pertinent to this position. Please do not list former employers or relatives.

01. Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Email

Relationship

Years Known

02. Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Email

Relationship

Years Known

03. Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Email

Relationship

Years Known

Verification, Authorization & Agreement

Electronic Confirmation of Consent*

The information I have provided in this application for employment to the Vestavia Hills Library in the Forest (employer) is true, correct and complete. I understand that false, incomplete or misrepresented information of any kind, will be sufficient cause for my application to be rejected, or, if discovered after I am employed, cause for immediate termination of my employment.

I authorize the employer (or its agent) to contact and obtain information about me from previous employers, educational institutions and references I have provided, and any other party necessary to verify the accuracy of information I have provided in this application, a related employment resume or a personal interview. I further authorize the employer to request a report concerning my background, references, character, past employment, education, motor vehicle records and criminal or police records, including those made by both public and private organizations.

I waive, release and discharge any claims or actions that I may otherwise have against the employer or any person, firm or corporation that solicits, provides, or evaluates information in connection with my employment application. I agree to participate in a drug screening test (at the employer’s expense) as a condition to my application for employment being considered and, if hired, to participate in random drug testing as may be requested or required by the employer during the course of my employment. I understand that a positive test result may adversely affect my eligibility for employment or continued employment.

If hired, I agree to abide by the policies, rules and regulations of the Vestavia Hills Library in the Forest. I also understand that, if hired, any employment is subject to modification or termination at any time in the sole discretion of the employer.

I understand and agree.

Date*

Employment Application

Education

Previous Employment

References

Verification, Authorization & Agreement

Member of the Public Libraries in Jefferson County (PLJC)

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