McCook Public Schools

Phone: 308-345-2510 opt 5 ** 700 West 7th Street, McCook, NE 69001 ** Fax: 308-217-1530
APPLICATION FOR EMPLOYMENT
PLEASE PRINT (Answer all questions)

NAME: __________________________________________________

ADDRESS: ________________________________________________ PHONE:_____________________________

POSITION APPLYING FOR: _______________________________________

Do you desire: Full-time work ________ Part-time work _________ Other _____________

EDUCATION: Name: Location: Graduated:

High School _____________________ _______________________ Yes No
College _____________________ _______________________ Yes No
Business _____________________ _______________________ Yes No
Military _____________________ _______________________ Yes No

EMPLOYMENT RECORD FOR PAST 5 YEARS (Starting with most recent)

Date MM/YY- MM/YY Name and Address of Employer Salary Position Reason for Leaving

REFERENCES – Name, Address, and Phone Number of Three References:

Name Address Phone Business

___________________________________________________ ____________________________________
Signature: Date:

DATE AVAILABLE TO START: ______________________________________

THE MCCOOK PUBLIC SCHOOL DISTRICT DOES NOT DISCRIMATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, SEX, DISABILITY, MARITAL STATUS, OR AGE IN ADMISSION OR ACCESS TO TREATMENT OF EMPLOYMENT
IN ITS PROGRAMS AND ACTIVITIES. IF YOU FEEL YOU HAVE BEEN DISCRIMINATED AGAINST, OR HAVE INQUIRIES REGARDING GRIEVANCE ACTIVITIES OR COMPLIANCE WITH TITLE IX, TITLE VI, OR SECTION 504 CONTACT:
SUPERINTENDENT OF SCHOOLS, 700 WEST 7TH STREET, MCCOOK, NE 69001; 308-345-2510. THE MCCOOK PUBLIC SCHOOL DISTRICT IS AN EQUAL OPPORTUNITY EMPLOYER.