Thank you for showing interest in working at the Brownstown Public Library. Please print and return it to the circulation desk or you can email it to brownstownpl@brownstownpl.org.
Employment Application
Brownstown Public Library
120 E. Spring Street
Brownstown, IN 47220
812-358-2853
Employment Application
Brownstown Public Library is an Equal Opportunity Employer and all applicants will be considered for employment without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job-related handicap.
First Name: _____________________ Middle: ____________________ Last Name: ____________________________
Address: ___________________________________ City: __________________ Zip Code: ____________________________
Phone No.: ( )________________ Email address:______________________________________
Application Date: ________________
Position applying for:
______ Clerk / Circulation duties (requires computer/Internet skills)
______ Janitor / Cleaning
You must be 16 years of age to work at the Brownstown Public Library. Check here if you are at least 16 years of age: ______
Are you legally entitled to work in the United States? ___________
Do you have any relatives currently working at the Brownstown Public Library? ______
If yes, please list name and relationship: _____________________________________
Do you own a valid Evergreen Indiana library card? ___________ If yes, what is your library card number? ________________________
Is your library card fine free? ___________
AVAILABILITY
The Brownstown Public Library does not hire full-time employees, only part-time. BPL does not offer insurance. Applicants must be able to work 2-3 Saturdays each month.
A typical work schedule includes a combination of day, evening, and Saturday hours.
Are you available to work this type of schedule? ___________
Please list the times you are available per week:
Mondays Hours: _____________ Check here if ANY on Mondays: ______
Tuesdays Hours: _____________ Check here if ANY on Tuesdays: ______
Wednesdays Hours: _____________ Check here if ANY on Wednesdays: ______
Thursdays Hours: _____________ Check here if ANY on Thursdays: ______
Fridays Hours: _____________ Check here if ANY on Fridays: ______
Saturdays Hours: _____________ Check here if ANY on Saturdays: ______
If unable to work the hours the library is open, please list day/hours of your prior commitments: ____________________________________________________________________________________________________________________________________________________________________________
List the maximum hours per week you would be available ________
EDUCATION
Please indicate the highest grade completed:
________ Did not complete high school
________ Completed GED
________ Currently in high school
________ Graduated from high school
________ Some college, no degree
________ One-year vocational diploma
________ Two-year associate degree
________ Bachelor’s degree
________ Graduate degree
High School Name: ________________________________ Address:_____________________________ _______________________________________________
Dates attended: ____________________ GPA: ________ Graduation Date: ____________________
Degree Earned: ______________________
College or University Name: __________________________________ Address: _____________________________________________
Dates attended: ____________________ GPA: ________ Graduation Date: ____________________
Degree Earned: ______________________
COMPUTER HARDWARE AND SOFTWARE SKILLS
Please check all of the following browsers, email, and computer programs in which you have experience:
________ Internet Explorer
________ Mozilla Firefox
________ Google Chrome
________ Bing
________ Microsoft Outlook
________ Gmail
________ Yahoo Mail
________ Microsoft Word
________ Microsoft Excel
________ Microsoft Power Point
Please check all the equipment in which you have experience and the brand:
________ E-reader or Tablet __________________________ (Kindle, iPad, Nook, Kobo)
________ Smartphone _________________________ (Android, BlackBerry, iOS or Windows OS)
________ Laptop or computer __________________________ (Windows or Mac OS)
Please check all the library databases in which you have experience:
________ Overdrive
________ Hoopla
________ HeritageQuest
Do you stream movies or television at home? ________
Other equipment or software (please specify)__________________________________________________________________________
Please indicate any additional experience that you have had with computers, software packages and computer training classes you have taken: _______________________________________________________________________________________________________
BACKGROUND INFORMATION
Are you currently employed? ______ If so, where? ________________________________________________
Reason for leaving: _______________________________________________________________________________
Date available to start employment at BPL: ________________
Do you have reliable transportation to get to work? ______
Have you ever been counseled or disciplined for being late to work? ______
If you can answer yes to any of the four following questions then please explain on a separate paper and attach to this application:
- Is your employer presently investigating you for misconduct? ______
- Have you ever been discharged or asked to resign from a prior position? ______
- Have you ever been convicted of a crime other than a minor traffic offense or entered a plea of guilty or has any court ever deferred proceedings and placed you on some probation for any crime? ______
- Have you ever been charged with, pleaded guilty to, or been convicted of any crime involving sexual abuse or other moral turpitude? ______
WORK EXPERIENCE
List three employers. Start with present or most recent employer.
Company: _______________________________________ Employer Telephone No: _________________
Employer email: _______________________________________
Dates employed (Month/Year) From: __________ To: __________ Ending Pay Rate:_________________
Supervisor Name/Title: _____________________________________
Job title: _______________________ Description of your duties: ____________________________________
Reason for leaving: _________________________________________________________________________________________
Company:_______________________________________ Employer Telephone No: _________________
Employer email: _______________________________________
Dates employed (Month/Year) From: __________ To: __________ Ending Pay Rate:_________________
Supervisor Name/Title: _____________________________________
Job title: _______________________ Description of your duties:_____________________________________
Reason for leaving: _________________________________________________________________________________________
Company:_______________________________________ Employer Telephone No: _________________
Employer email: _______________________________________
Dates employed (Month/Year) From: __________ To: __________ Ending Pay Rate: _______________________
Supervisor Name/Title: _____________________________________
Job title: _______________________ Description of your duties: ___________________________________
Reason for leaving: _________________________________________________________________________________________
May we contact your present employer? ________
If you were employed under another name, please provide name(s): ________________________________________
Please explain any periods of unemployment: __________________________________________________________
Please list any scheduled events/special occasions for which you will be requesting time off in the next six months (such as vacation, family reunions, surgery, etc.: ____________________________________________________________________________
Describe any skills, experience, foreign language, or specialized training that you feel will be helpful in considering your application: _________________________________________________________________________________________
REFERENCES
List three names of those persons who can provide references for your educational achievement, training, employment experiences and general character traits.
Name:___________________________________________ Address:______________________________
Occupation: _______________________________________ Phone No: _______________________
How long have you known this person? __________________
Type of Reference:
Personal _______ Work ________ School ________
Name:___________________________________________ Address:_______________________________
Occupation: _______________________________________ Phone No: _______________________
How long have you known this person? __________________
Type of Reference:
Personal _______ Work ________ School ________
Name: ___________________________________________ Address: ______________________________
Occupation: ________________________________________ Phone No: _______________________
How long have you known this person? __________________
Type of Reference:
Personal _______ Work ________ School ________
Failure to complete application will make it invalid.
This application shall be valid for three years. Renewal is required for further consideration.
Testing of organizational skills and a personal interview is required before the Trustees can approve employment.
PLEASE READ CAREFULLY BEFORE SIGNING
I certify that the information contained in this application is true and complete to be best of my knowledge. I acknowledge and agree that any false statement, misleading answer, omission, concealment, unrequested information, or failure to answer any question fully, completely, and accurately will be grounds for not hiring me or terminating my employment irrespective of when the information is discovered.
I authorize investigation and verification of all statements contained herein. I authorize the references listed above and employers to give you any and all information concerning my previous employment and any pertinent information that they may have, personal or otherwise, and release all parties from all liability for any damage that may result.
I acknowledge that if I become employed at the Brownstown Public Library my employment is for no definite period, and I will be employed “at will,” which means that I will be free to terminate my employment at any time for any reason. Likewise, the Brownstown Public Library is free to terminate my employment at any time and for any reason except as prohibited by law.
____________________________________
Signature of Applicant
