ASTERISK Employment Application

Employment Application
Please complete application online and include a hard copy (printed copy) in the portfolio.
Current Grade:
Date:
Student ID#:
Last Name:
First Name:
Mailing Address:
City:
Zip/Postal Code:
SS Number:
I will provide when offered employment.
Home Phone:
E-mail Address:
Cell Phone:
Position:
Salary Desired:
Hours Available to Work (Students must be available to work May 29-June 19, 2015):
Mon
Tues
Wed
Thurs
Fri
Sat
Sun
Are you available to work holidays?
Full-time
Part-time
yes
no
Full or Part-time
When are you available to begin work?
Education
Type of School
Name of School and Complete Mailing Address
No. Years Completed
Major or Degree
High School
College, Bus. or
Trade School
Professional School
Other
Have you ever been convicted of a crime:
yes
no
yes
no
If yes, please explain
Do you have a drivers license?
Continue on the next page
Previous Employment (list up to 2)
Have you previously worked as an A.S.T.E.R.I.S.K. intern?
yes
no
1.
Name of Employer:
Name of Last Supervisor:
Dates of Employment:
From:
To:
From:
To:
Salary:
Complete Address:
Phone #:
Last Job Title:
Reason for Leaving (Be Specific):
List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company:
May we contact your employer:
yes
no
2.
Name of Employer:
Name of Last Supervisor:
Dates of Employment:
From:
To:
From:
To:
Salary:
Complete Address:
Phone #:
Last Job Title:
Reason for Leaving (Be Specific):
List the jobs you held, duties performed, skills used or learned, advancements, or promotions while you worked at this company:
May we contact your employer:
yes
no
Continue on the next page
Skills:
Typing:
Computer:
PC
Mac
Both
Applications (List All That Apply):
Other Skills:
Please list 2 references other than relatives and previous employers
Name
Position
Company
Telephone
Use this space to add any additional information necessary to describe your full qualifications for the position which you are applying:
An Equal Opportunity/ADA/504/Title VI/Title VII/Title IX/ADEA Employer”
HR-85 (Rev. 06/06)
San Bernardino City Unified School District
Human Resources -Classified Employment Office
Please complete this form for statistical purposes. The information provided will not be used to make any employment decisions
that affect you.
Sex:
Ethnic Category (Select one):
GENERAL RELEASE
For Community Access Cablevision, Photographs, Videotaping, Interview Comments, and Posting
on the Internet
TO: Parents
FROM: Principal's Office
Occasionally, the District and organizations/associations connected with the District would like to use the name,
photograph(s), video recording, and/or interview comments of students for educational and promotional purposes,
including District-generated news articles and brochures. Such images and comments are used for news purposes
only and not for commercial use.
As part of each school's parent/community informational program, a school may wish to place students' pictures and/
or
names on the Internet or the school's web page.
All photography, video recording, student comments, and posting on the Internet is done by legitimate news media
personnel or School District personnel. In order to use such material, parental consent is necessary for any student
under
18 years of age.
General Release
Please fill out this form and return to your school
Please indicate below if you give permission for your child's name, image, or comments to be used:
In District brochures and press releases
(press releases and accompanying photos may
Yes
No
be published by local, state, or national media)
District-sponsored Internet site/web page
Student Name:
Student School
Grade:
Parent/Guardian Signature:
Original Signature Required in the ASTERISK Portfolio
Date:
Yes
No
PERMISO GENERAL
Para Televisión de Cable con Acceso a la Comunidad, Fotografías, Cintas de Video y Colocamiento en el Internet
PARA: Padres
DE PARTE DE: Oficina del Director(a)
De vez en cuando, al Distrito y a las organizaciones/asociaciones relacionadas al Distrito, les gustaría utilizar el nombre,
las fotografías, las grabaciones y/o los comentarios de entrevista de estudiantes con propósitos publicitarios,
incluyendo artículos de noticias y folletos producidos por el Distrito. Tales imágenes y comentarios se utilizan
únicamente para propósitos de noticias y no para uso comercial.
Como parte del programa informativo de los padres/la comunidad de cada escuela, quizá la escuela desee poner
fotografías y/o nombres de estudiantes en el Internet o en el sitio Web de la escuela.
Todas las fotografías/cintas de video, comentarios del estudiante y el colocamiento en el Internet son tomadas/hecho
por personal legítimos de medios publicitarios o por el personal escolar del Distrito. A fin de usar tal material, el
consentimiento de los padres es necesario para cualquier estudiante menor de 18 años de edad.
PERMISO GENERAL
Favor de llenar este formulario y regresarlo a su escuela.
Por favor indiquen abajo si dan su consentimiento para que el nombre, la imagen o los comentarios de su hijo(a) se
utilizen:
Si
No
En folletos y noticias de prensa
(las noticias de prensa y las fotografías que las acompañan
pueden ser publicadas por medios publicitarios locales, estatales o nacionales)
Sitio/página Web en el Internet patrocinado por el Distrito
Nombre del estudiante:
Escuela:
Grado:
Firma de padre, madre o encargado:
Se requiere firma original en el portfolio de ASTERISK
Fecha:
Si
No