St. Benilde School 1801 Division St.

Metairie, LA 70001 504-833-9894 stbenilde.com

SUPPORT STAFF EMPLOYMENT APPLICATION Teaching Assistants, Aides, Coaches, After Care & Camp Counselors, Secretarial, Maintenance

PERSONAL INFORMATION

Applicant’s Name: (Last) (First) (Middle)

Present Address: (Street) (City) (State) (Zip)

How long at present address___________ Email Address:

Permanent Address (if different)_________________________________________ (Street) (City) (State) (Zip)

Telephone: (H) (C)

Date of Birth: Age:

Are you a practicing Catholic? YES / NO

TRAININGS/CERTIFICATIONS

List recent and relevant trainings and certifications you have received:

Expected Hourly Pay $__________________

EXPERIENCE AND/OR ABILITY TO DIRECT ACTIVITIES Give a brief explanation of your experience and number of years of experience:

EDUCATIONAL BACKGROUND (List in chronological order)

If you have not as yet completed associations or undergraduate studies, please indicate the pending date for receipt of your associate’s or bachelor’s degree.

Please list any foreign language with which you have a speaking or reading facility and indicate the degree of proficiency.

NAME OF SCHOOL MAJOR(S)/MINOR(S) DEGREE DATE OF GRADUATION

WORK EXPERIENCE (In chronological order) Give particulars of all previous and present employment (after college) beginning with your most recent position. Include United States military service and type of military discharge and any former employment with an agency of the Archdiocese, its parishes or related entities. Periods of unemployment, and reasons, should also be shown. If additional space is required, use a supplemental sheet.

TOTAL YEARS OF EXPERIENCE:

1. Organization Name

2.Address,City,State

Dates Employed

Month Year

Base Rate of Pay at End of Employment

1. Type of Work Performed & Title Supervisor Name

Specific Reason for Leaving

1.

2. From:

$

Per

1.

2.

1.

2. From:

$

Per

1.

2.

1.

2. From:

$

Per

1.

2.

1.

2. From:

$

Per

1.

2.

REFERENCES

PERSONAL INFORMATION

1. Have you ever for any reason been suspended, dismissed, or asked to resign a position of employment? YES NO

2. Have you ever been dismissed from any position for unprofessional conduct or unfitness for service? YES NO

Explain any “yes” answers on an attached statement.

Full Name of Reference Address, City, State Telephone Position

(Present Employer)

1

(Previous Employer or College Advisory)

2

(Other/Excluding Relative)

3

(Other/Excluding Relative)

4.

PART II Your application cannot be processed without this information. 1. Why do you want to work in a CATHOLIC school/early childhood learning center?

2. Please describe any aspect of your training or experience that would be an asset in the position for which you are applying.

STATEMENT: St. Benilde School is an Equal Opportunity Employer and does not discriminate against applicants or employees by reason of race, age, sex, handicap, or national origin. This non-discriminating policy applies to hiring, training, promoting, salaries, transfers, and working conditions.

STATEMENT: I understand that any omission or misrepresentation on this application may result in the refusal of any employer to hire me or in the termination of such employment if hired.

I am interested in: Secretarial; an assistant teaching position/aide; Care/Camp Counselor Maintenance

SIGNATURE OF APPLICANT:

DATE: