LEGACY HIGH SCHOOL

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION DATE:___________________

Name (Last Name First)____________________________________Social Security

No.____________________

Present
Address______________________________City_______________State_________Zip_____________

Permanent Address___________________________City_______________State_________Zip_____________

Home Phone:__________________Cell:_________________DOB_______________Referred
by____________

GENERAL INFORMATION
Subjects of Special Study/Research, Work, or Special Training/Skills
__________________________________________________________________________________________
__________________________________________________________________________________________

EMPLOYMENT DESIRED
Position_____________________________Date You Can Start________________Salary
Desired____________

Are You Employed _____Yes______No If So, May We Inquire Of Your Present

Employer?______Yes_____No

FORMER EMPLOYERS

Date Month and Year Name & Address of Employer Salary Position Reason for
Leaving

From
To

From
To

From
To

Have you ever been convicted of a crime? ______yes______no

If yes, please explain:
__________________________________________________________________________________________

I certify that the answers given by me in this application are true and correct without omissions of any kind. I agree that the school shall not be held
liable in any respect if my employment is terminated because of false statements, answers, or omissions made by me in this application. I authorize
the school to make any investigation of my personal or employment history and authorize any former employers, person, firm, corporation or
government agency to disclose to the school any information they may have regarding me. In consideration of the review of this application, I
hereby release the school as well as all providers of information from any liability and for any damage which may result from the furnishing and
receiving of this information. A copy of this authorization and release is as valid as the original and should be recognized as such.
________________________________________________________________ ______________________________________________________
Signature of applicant Date