Union Area School District General Employment Application

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Email *

Last name, First name *

Current Address: Street , City State Zip *

Social Security Number *

Home or Cellular Telephone *

Work Telephone

Positions Applying for (check all that apply): *

Custodial/Maintenance

Secretarial

Para-Professional

Security

Bus Monitor

Bus Driver

Other:

Required

Are you interested in (check all that apply): *

Full Time

Part Time

Substitute

Summer Help (custodial only)

Required

Clearances to be submitted with application (please check to indicate you have these clearances): *

Criminal History Record (Act 34)

Child Abuse Clearance (Act 151)

Finger Prints (Act 114)

Gun Permit (Act 235) for security position only

Required

Section 1418 of the Pennsylvania School Code requires a pre-employment examination and evidence of a tuberculosis test within a two year period. Before employment, evidence of such examination and test must be filed with the Superintendent's Office. No one may begin work before completing these examinations. *

I have read and understand the above statement.

Required

Section 111 of the Pennsylvania School Code requires prospective employees to submit with the employment application a report of criminal history record from the Pennsylvania State Police. Section 111 prohibits this employer from employing any person whose criminal history indicates that the applicant has been convicted within five years immediately preceding the date of the report of one of more specific offenses under the Crimes Code, 19 Pa. CSA 101 et seq. Applications submitted without the required criminal history record shall not be considered. Forms may be secured in the Superintendent's office or from the Pennsylvania State Police. *

I have not been convicted of a felony.

I have not been convicted of a child abuse crime nor am I under suspicion of a crime.

I declare that the information on this application is true and complete to the best of my knowledge, and I authorize investigation of all statements recorded herein. Further, I understand that the submission of false information will result in refection of this application.

Required

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