APPLICATION FOR EMPLOYMENT

SUMMIT SCHOOL DISTRICT 54-6

PO BOX 791

SUMMIT, SD 57266-0791

PHONE: 605-398-6211

Position Applied For:                                                                                                                     Date:

Last Name:                                                                         First Name:                                                        MI:

Address:                                                                                              City, State, Zip:

Telephone:                                                                                        Social Security Number:

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References:       Give three personal references excluding relatives.

Name                                                                                    City                                                        Phone

Name                                                                                    City                                                        Phone

Name                                                                                    City                                                        Phone

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Current Position                                                                                               Dates of Employment:                   to

Current Supervisor                                                                                                          May we contact?

Supervisor’s Phone/Address

Describe Duties:

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Past Position                                                                                                      Dates of Employment:                   to

Supervisor                                                                                                                          May we contact?

Supervisor’s Phone/Address

Describe Duties:

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Past Position                                                                                                      Dates of Employment:                   to

Supervisor                                                                                                                          May we contact?

Supervisor’s Phone/Address

Describe Duties:

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Why would you be the best person for the job?

Other information you would like us to know:

Date available if hired: