Larimore Public School District

1) Position Applying for:

2) Date of Application:

Click on the letters to select a date. You will need to select today's date even though it is already there.

Personal Information

3) Last Name:

4) First Name:

5) Middle Name: (optional)

6) City:

7) State:

8) Zip:

9) Telephone Number:

10) Email Address:

11) Best time of day to reach you.

12) Have you ever filed an application with us before?

Yes

No

13) If you answered yes to question 12, when did you last apply? (optional)

14) Have you ever been employed with us before?

Yes

No

15) If you answered yes to question 14, when were you last employed by Larimore Public Schools? (optional)

Current employment

16) Are you currently employed?

Yes

No

17) May we contact your present employer? (optional)

Yes

No

N/A

18) Supervisor's Name and Phone Number: (optional)

19) Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?

Proof of citizenship or immigration status will be required upon employment.

Yes

No

20) Do you qualify for Veteran’s Preference?

Yes

No

21) If you answered yes to question 20 plese upload your certificate. (optional)

Max 10 files | 200 MB limit

22) Have you ever been convicted of a felony?

Yes

No

23) Do you have any pending criminal charges against you?

Yes

No

24) Date available to start work:

Click on the letters to select a date. If you want to pick today's date you will need to select it even though it is already there.

High School Education

Please provide information about current or previous education. For areas you have not completed please leave blank.

25) Name and Address of school: (optional)

26) Course of Study: (optional)

27) Year Completed: (optional)

28) Diploma or Degree Received: (optional)

Undergraduate/Technical Education

Please provide information about current or previous education. For areas you have not completed please leave blank.

29) Name and Address of school: (optional)

30) Course of Study: (optional)

31) Year Completed: (optional)

32) Diploma or Degree Received: (optional)

Graduate/Professional Education

Please provide information about current or previous education. For areas you have not completed please leave blank.

33) Name and Address of school: (optional)

34) Course of Study: (optional)

35) Year Completed: (optional)

36) Diploma or Degree Received: (optional)

Other Education

Please provide information about current or previous education. For areas you have not completed please leave blank.

37) Name and Address of school: (optional)

38) Please describe this type of education: (optional)

39) Course of Study: (optional)

40) Year Completed: (optional)

41) Diploma or Degree Received: (optional)

1 Work Experience:

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations, which indicate race, color, religion, gender, national origin, disabilities or other protected status.

42) Employer: (optional)

43) Address: (optional)

44) Telephone Number (optional)

45) Starting/Present Job Title: (optional)

46) Supervisor (optional)

47) Reason for Leaving: (optional)

48) Work Performed (optional)

49) Dates Employed From/To (optional)

50) Hourly Rates/Salary Starting/Final (optional)

51) May we Contact? (optional)

Yes

No

2 Work Experience:

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations, which indicate race, color, religion, gender, national origin, disabilities or other protected status.

52) Employer: (optional)

53) Address: (optional)

54) Telephone Number (optional)

55) Starting/Present Job Title: (optional)

56) Supervisor (optional)

57) Reason for Leaving: (optional)

58) Work Performed (optional)

59) Dates Employed From/To (optional)

60) Hourly Rates/Salary Starting/Final (optional)

61) May we Contact? (optional)

Yes

No

3 Work Experience:

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations, which indicate race, color, religion, gender, national origin, disabilities or other protected status.

62) Employer: (optional)

63) Address: (optional)

64) Telephone Number (optional)

65) Supervisor (optional)

66) Starting/Present Job Title: (optional)

67) Reason for Leaving: (optional)

68) Work Performed (optional)

69) Dates Employed From/To (optional)

70) Hourly Rates/Salary Starting/Final (optional)

71) May we Contact? (optional)

Yes

No

72) Please describe any gaps in employment. (optional)

73) Describe any specialized training, apprenticeship, job related skills, military training, professional, trade, or business activities. (optional)

74) State any additional information you feel may be helpful to us in considering your application. (optional)

75) Capabilities

Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING. Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given.

Yes

No

1 Personal/Professional References:

Please provide information about a personal or professional reference.

76) 1 Reference Name: (optional)

77) 1 Reference Phone Number (optional)

78) 1 Reference Best Time to Call (optional)

79) 1 Reference Occupation: (optional)

2 Personal/Professional References:

Please provide information about a personal or professional reference.

80) 2 Reference Name: (optional)

81) 2 Reference Phone Number (optional)

82) 2 Reference Best Time to Call (optional)

83) 2 Reference Occupation: (optional)

3 Personal/Professional References:

Please provide information about a personal or professional reference.

84) 3 Reference Name: (optional)

85) 3 Reference Phone Number (optional)

86) 3 Reference Best Time to Call: (optional)

87) 3 Reference Occupation: (optional)

Applicant's Statement

Please read and agree to the following statements.

88) Applicant's Statement:

I certify that answers given herein are true and complete.

Agree

Disagree

89) Applicant's Statement:

I agree to a background check to be completed by the North Dakota Bureau of Criminal Investigation if I am offered this job.

Agree

Disagree

90) Applicant's Statement:

I hereby understand and acknowledge that, unless otherwise defined by law, any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by a written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive organiza

Agree

Disagree

91) Applicant's Statement:

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Agree

Disagree

92) Applicant's Statement:

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

Agree

Disagree

Document Upload

Please upload any of the following documentation that you have available. If your file is too large to submit please email it to the high school principal Kal Triplett at kal.triplett@k12.nd.us.

93) Cover Letter: (optional)