HANNIBAL PUBLIC SCHOOLS Administrative Office 4650 McMasters Avenue Hannibal, MO 63401 (573) 221-1258 APPLICATION FOR SUMMER EMPLOYMENT ON SCHOOL MAINTENANCE NAME: ________________________________________

DATE:_______________________________

ADDRESS: __________________________________________ TELEPHONE # ________________________ __________________________________________ SOCIAL SECURITY #___________________ DATE OF BIRTH: _____/_____/_____ The work may involve heavy lifting and hard physical labor. WILL YOU BE CAPABLE OF COMPLETING TASKS?

Y/N

ARE YOU A RESIDENT OF HANNIBAL SCHOOL DISTRICT? Y/N ARE YOU ENROLLED IN HIGH SCHOOL?

Y/N

HOW LONG? ____________

WHERE? ____________________

YEAR YOU GRADUATE(D) FROM HIGH SCHOOL: __________ ARE YOU NOW ATTENDING COLLEGE? YEAR IN COLLEGE: ________________

Y/N

WHERE? ____________________ DATE YOU CAN START: ________________

PARENTS’ NAME: ___________________________________________________________________________ PARENTS’ ADDRESS: ________________________________________________________________________

KIND OF WORK

WORK EXPERIENCE EMPLOYER

LENGTH OF EMPLOYMENT

REFERENCES Persons listed will be contacted concerning your qualifications, character, habits, etc. NAME RELATIONSHIP ADDRESS CITY

2016