Clerk Application

Clerk application

585-889-2200
3237 Chili Ave, 14624

* Indicates required field

Name *

Date *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email Address *

Highest Grade Completed *

List three adult references who know you well. Please exclude relatives.

Name *

Relationship to you *

Address *

Phone Number *

Name *

Relationship to you *

Address *

Phone Number *

Name *

Relationship to you *

Address *

Phone Number *

Please describe any volunteer or paid positions you have held in the past three years.

Employer *

Dates Employed *

Reason for leaving *

Employer *

Dates Employed *

Reason for leaving *

Employer *

Dates Employed *

Reason for leaving *

Please list any additional skills and qualities that would recommend you for a job at the library. *

Specific duties and scheduling will be discussed at the job interview.

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