LAFAYETTE COUNTY SCHOOL DISTRICT PO BOX 950 LEWISVILLE, AR 71845 870-921-5500

AN EQUAL OPPORTUNITY EMPLOYER It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classification.

Classified Staff Application

PERSONAL DATA

In compliance with Arkansas law 6-17-414, the Lafayette County School District requires a criminal background check of all new employees. Refusal to consent to a criminal background check will remove an applicant from consideration for employment.

EDUCATIONAL AND PROFESSIONAL PREPARATION

WORK EXPERIENCE

ADDITIONAL DATA

THIS APPLICATION, IF PROPERLY COMPLETED, WILL BE KEPT ON FILE FOR THREE YEARS. IF THE APPLICANT IS NOT APPOINTED, AND HE/SHE WISHES FOR THE APPLICATION TO REMAIN CURRENT, THEN RENEWAL MUST BE MADE IN WRITING. IF REQUEST FOR RENEWAL IS NOT RECEIVED, THE APPLICATION WILL BE DESTROYED.

REFERENCES (GIVE NAME OF SUPERINTENDENTS, PRINCIPALS, MAJOR PROFESSORS, SUPERVISORS, COOPERATING TEACHER, AND ANY OTHERS WHO HAVE OBSERVED AND KNOWN YOUR WORK.

REMINDERS TO APPLICANTS: ATTACH COMPLETE COPY OF TRANSCRIPT, RESUME, CERTIFICATES OF CERTIFICATIONS OR ANY OTHER HELPFUL DOCUMENT.

THE FACTS SET FORTH IN MY APPLICATION FOR EMPLOYMENT SHALL BE CONSIDERED TRUE AND COMPLETE. I UNDERSTAND THAT, IF EMPLOYED, FALSE STATEMENTS ON THIS APPLICATION SHALL BE CONSIDERED SUFFICIENT CAUSE FOR DISMISSAL. YOU ARE HEREBY AUTHORIZED TO MAKE ANY INVESTIGATION OF MY PERSONAL HISTORY AND FINANCIAL AND CREDIT RECORD THROUGH ANY INVESTIGATIVE OR CREDIT AGENCIES OR BUREAUS OF YOUR CHOICE. I WAIVE THE RIGHT TO VIEW OR EXAMINE ANY PERSONAL OR EMPLOYMENT REFERENCE FORMS THAT ARE COMPLETED AND RETURNED TO THE DISTRICT BY THE PERSONS WHOM I LIST AS REFERENCES ON THIS APPLICATION. I FURTHER AGREE TO TAKE ANY MEDICAL EXAMINATION REQUIRED BY LAFAYETTE COUNTY SCHOOL DISTRICT.