Part-time Maintenance Position

Application for Employment
St. Louis Catholic School Certified Staff

(Maintenance, kitchen, secretarial/clerical, bookkeeping, accounting, school nurse or other support positions)

Thank you for your interest in employment as an educator with us. With respect to religion and sexual orientation, as permitted by law, we reserve the right to exercise discretion in employment decisions to employ persons who share and are committed to the values and mission of the Catholic Church. The information gathered in this application is designed to help us provide the highest quality Catholic education for students enrolled in our school and to assist us in providing a safe and secure environment. Please read the statements below.

I understand and agree that:

1. I certify that all information furnished by me in this application is complete, true and correct to the best of my knowledge. I understand that falsification of information including omission of any information sought may lead to refusal to hire me, withdrawal of an employment offer, or termination of my employment.

2. If I am hired, I agree that I am employed at will and my employment can be terminated at any time for any reason by either the employer or me without liability for wages or salary except such as vacation pay that may have been earned at the date of such termination.

3. If I am called to interview with this employer or become employed as a result of the interview process, I hereby authorize the employer conduct a thorough investigation of my entire work history and may verify all data given in my application for employment, related papers or oral interviews and obtain additional information relating to my background. I authorize all schools, companies, corporations, law enforcement agencies to supply information concerning my background including but not limited to criminal records, motor vehicle records, education and employment verification, (past and present), reference checks and military service verification. I specifically waive written notice of such disclosures from my former employers. I understand that falsification of data so given or other derogatory information discovered as a result of this investigation may prevent my being hired, or if hired, may subject me to immediate dismissal.

4. I agree to observe all of the guidelines and policies for the employer where I am applying.

5. I understand that the school has a zero tolerance for abuse and takes all allegations of physical or sexual abuse seriously. I further understand that the school cooperates fully with the authorities to investigate all cases of alleged abuse. Abuse of minors or vulnerable adults is grounds for immediate dismissal and possible criminal charges.

6. I understand that this is an application for employment and that no offer of employment is being made at this time. If hired, I understand that although effort is made to accommodate individual preferences, business needs may at times make the following conditions mandatory: overtime, shift work, a rotating work schedule, or a work schedule other than Monday through Friday. I also understand that if I am hired, said employment is not for any definite period-of-time. If I am offered employment, the terms and conditions of my employment will be explained but that said conditions and terms are subject to change, do not create an employment contract, and do not alter the at-will arrangement.

7. I understand this application is good only for ninety, (90), days from today’s date. If I still desire a position after this application expires, it will be my responsibility to fill out a new application. Otherwise I will not be considered for employment after this application expires. I understand I can withdraw from the application process at any time.

I have read and understood the above statement. REQUIRED I agree Please fill out this field.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Do you have access to transportation which will enable you to get to and from work? REQUIRED Yes No Please fill out this field.

Have you applied here before? Yes No

If yes, what year? Please enter valid data.

What religion do you practice? REQUIRED Please fill out this field. Please enter valid data.

If you are not of the Catholic faith, what is the name of your Church? Please enter valid data.

Are you an active member? Yes No

Are you a member of a Catholic parish? Yes No

If so, what Parish? Please enter valid data.

How long have you been a member? Please enter valid data.

Date Available for Employment REQUIRED Please fill out this field. Please enter a date.

What interests you about the position: REQUIRED Please fill out this field.

What has you prepared for the position: REQUIRED Please fill out this field.

Have you been convicted or plead guilty to a felony in the following categories within the last ten years? (Please see categories below) REQUIRED Yes No Please fill out this field.

Narcotics offense to include the (1) Cannabis Control Act, (2) Illinois Controlled Substance Act, (3) Methamphetamine Control and Community Protection Act, or (4) any attempt to commit any of the offenses listed in items (1) through (3). Any offense committed or attempted in any other state or against the laws of the United States that, if committed or attempted in this State would have been punishable as one or more of the offenses listed in items (1) through (4) above. Sex offense as defined in in Sections 11-6, 11-9 through 11-9,5 inclusive, and 11-30 of the Criminal Code (CC) of 1961 or the CC of 2012; Sections 11-14 through 11-21, inclusive of the CC of 1961 or the CC of 2012; Sections 11-23 (if punished as a Class 3 felony), 11-24, 11-25, and 11-26 of the CC of 1961 or the CC of 2012; and Sections 11-1-20, 11-1-30, 11-1-40, 11-1-50, 11-1-60, 12-4-9, 12-12, 12- 14, 12-14.1, 12-15, 12-16, 12-32, 12-33, and 12C-45 of the CC of 1961 or the CC of 2012. Conviction of sexual or physical abuse of any minor under 18 years of age. Conviction for committing attempted first degree murder or for committing or attempting to commit first degree murder or a Class X felony.

*Convictions that have been legally sealed or expunged and arrests should not be disclosed. While a conviction record is considered, it is not automatic grounds for rejecting an application for employment. Circumstances surrounding the conviction are considered.

If yes, please explain: Please enter valid data.

Do you have any commitment to another employer that might affect your employment with the parish, school, or institution in the Diocese of Springfield? REQUIRED Yes No Please fill out this field.

Are you currently eligible to work in the United States? REQUIRED Yes No Please fill out this field.

Are you under 18 years old? REQUIRED Yes No Please fill out this field.

Are you presently employed? REQUIRED Yes No Please fill out this field.

In the last ten years, how many times have you been fired or asked to resign? REQUIRED Over 10 times 6-10 times 4-5 times 2-3 times Once Never Please fill out this field.

Have you ever been discharged from a position for making threats, fighting, or any incidents involving violence? REQUIRED Yes No Please fill out this field.

Please describe all job situations in which you were fired or asked to resign?

Educational Background

High School Name & Location REQUIRED Please fill out this field. Please enter valid data.

College - Name & Location Please enter valid data.

Degree & Major Please enter valid data.

List all employment in the last 10 years regardless of length of employment, starting with the most recent or

Please list start & end date, name of employer, position held, and reason for leaving REQUIRED Please fill out this field.

Additional skills or qualifications (professional administrative training, certification and experience, Catholic school experience) REQUIRED Please fill out this field.

Please list 3 academic or professional references (Names, Phone Numbers/Email Address, and How long you have known this person) REQUIRED Please fill out this field.

By typing my full name into the box below, I certify that the information I have given is honest and complete. REQUIRED Please fill out this field. Please enter valid data.