JOB APPLICATION - Attendance Specialist

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Regional Office of Education (ROE) 1
507 Vermont St., Quincy, Illinois 62301
217-277-2080

Regional Office of Education 1 is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

PLEASE FILL OUT ALL OF THE SECTIONS BELOW:

Applicant Information

Applicant Name: *

Address: *

City, State and Zip Code: *

Telephone Number: *

Email Address: *

Date of Application: *

YYYY

Employment Position

Position(s) applying for: *

How did you hear about this position? *

On what date can you start working if you are hired? *

YYYY

Do you have reliable transportation to and from work? *

Yes

Other:

Personal Information

Are you a U.S. citizen or approved to work in the United States? *

Yes

What document can you provide as proof of citizenship or legal status? *

Job Skills/Qualifications

Please list below the skills and qualifications you possess for the position for which you are applying: (Note: Regional Office of Education 1 complies with ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.) *

Education and Training

High School Name *

High School Location (City, State) *

High School Year Graduated *

High School Degree Earned *

Education and Training

College/University Name

College/University Location (City, State)

College/University Year Graduated

College/University Degree Earned

Education and Training

Vocational School/Training Name

Vocational School/Training Location (City, State)

Vocational School/Training Year Graduated

Vocational School/Training Degree Earned

Previous Employment

Employer Name *

Job Title *

Supervisor Name *

Employer Address *

Employer Telephone *

Dates Employed *

Reason for Leaving *

Previous Employment

Employer Name

Job Title

Supervisor Name

Employer Address

Employer Telephone

Dates Employed

Reason for Leaving

Previous Employment

Employer Name

Job Title

Supervisor Name

Employer Address

Employer Telephone

Dates Employed

Reason for Leaving

References

Please provide 3 personal and professional reference(s) below:

Reference #1 Name *

Reference #1 Contact Information *

Reference #2 Name *

Reference #2 Contact Information *

Reference #3 Name *

Reference #3 Contact Information *

AT-WILL EMPLOYMENT

The relationship between you and the Regional Office of Education 1 is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without case, with or without notice, by you or the Regional Office of Education 1. No representative of ROE 1 has authority to enter into any agreement contrary to the foregoing "employment at will' relationship. You understand that your employment is "at will", and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Regional Superintendent or Assistant Regional Superintendent.

Applicant E-Signature *

Date *

YYYY

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