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Employment

Employment Application

Application for Employment

This application must be completed in its entirety. Please do not refresh your browser or your entries will be lost.

Position you are applying for: *

Job Type Full Time Part Time Hourly Temporary

Name * Street Address * Apt., Suite, Bldg. (optional) City * State * Zip Code * Phone * Email *

Are you at least 16 years old? * Yes No

Do you have the right to work in the United States? * Yes No

May we contact your current employer? * Yes No

If no, please indicate someone familiar with your work performance that we may contact (name and phone number)

Can you work: Evenings Weekends

Please check any current clearances that you have (Please note, all three are required upon offer of employment). PA Criminal PA Child Abuse FBI Criminal

Date of PA Criminal Clearance Date of PA Child Abuse Clearance Date of FBI Criminal Clearance

EDUCATION

Last High School Attended * City * State *

Highest Grade Completed (choose one) 9 10 11 12

Do you have a High School Diploma or G.E.D. Certificate? Yes No

Secondary Education (Please list colleges, universities, trade or technical schools or apprenticeship programs.)

Name of institution City State Number of years/months attended Degrees, credits, certificates or licenses Name of institution City State Number of years/months attended Degrees, credits, certificates or licenses Name of institution City State Number of years/months attended Degrees, credits, certificates or licenses

OTHER QUALIFICATIONS

Not all positions at Northland Public Library require a high school or college degree. We are very interested in knowing what experience you have (either through work, volunteering, etc.) which is relevant to the position you’re applying for. We encourage you to include that experience in the space(s) below.

List any trade, professional or skills certificates you hold. Summarize special skills, abilities, or experience which qualify you for this position.

BACKGROUND

Employment History

Employer Job Title Street Address Apt., Suite, Bldg. (optional) City State Zip Code Dates employed (start, end) Supervisor’s name, email and phone Reason for leaving Employer Job Title Street Address Apt., Suite, Bldg. (optional) City State Zip Code Dates employed (start/end) Supervisor’s name, email, and phone Reason for leaving Employer Job Title Street Address Apt., Suite, Bldg. (optional) City State Zip Code Dates employed (start/end) Supervisor’s name, email, and phone Reason for leaving

Professional References

Name * Relationship * Phone * Email * Name * Relationship * Phone * Email * Name * Relationship * Phone * Email * Upload Resume * Upload Cover Letter *

Certification, Authorization and Agreement

I certify that the information supplied by me on this application form and in my resume, if any, is true and complete and does not contain any falsifications, omissions or concealments of material fact. I authorize the Northland Public Library Authority to investigate the truth of this information and any other information I may supply during a pre-employment interview. * Date *

Please type any two numbers.

Certification, Authorization, and Agreement * *

300 Cumberland Road, Pittsburgh, PA 15237

412-366-8100

northland@northlandlibrary.org

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