Non-Instructional Application

SS#*

Position Desired*

Position Desired (Part Time or Full Time)*

Part TimeFull Time

Applicant's Name*

First NameLast Name

Email Address*

Address*

Address

Street Address Line 2

CityState

Zip

Telephone *

Date of Birth*

Date

Are you a U.S. Citizen?*

YesNo

If no, please indicate your status*

Emergency Contact's First and Last Name*

Emergency Contact's Telephone*

Do you smoke?*

Drink?*

Use Drugs?*

Are you applying for a Bus Driver position?*

Current CDL/Passenger License #*

Do you have an S endorsement to drive a school bus?*

YesNo

Have you had an accident in the last 3 years?*

YesNo

If yes, please describe*

Have you been ticketed for a moving violation in the last three years?*

YesNo

If yes, please indicate date(s) of offense*

Has your license ever been suspended or revoked?*

YesNo

If yes, please indicate date(s)*

Have you ever been convicted of a crime?*

YesNo

If yes, please describe*

Are you currently retired from or receiving benefits from a position covered by: TPAF, PERS, PFRS, SPRS, OR JRS*

YesNo

Please check appropriate level(s) of education*

Are you a veteran or have military experience?*

Military*

From*

To*

Boiler License*

YesNo

Class?*

LP*

HP*

Typing*

YesNo

Words per minute*

Computer*

YesNo

Bookkeeping & Accounting*

YesNo

Please list any other skills/licenses

Reference # 1 - First and Last Name*

Reference # 1 - Phone Number*

Please enter a valid phone number.

Reference # 2 - First and Last Name*

Reference # 2 - Phone Number*

Please enter a valid phone number.

Present Occupation*

Name of Employer (If not currently employed, list previous employer)*

Address of Employer (Street Address, City, State, Zip)*

Street Address, City, State, Zip

Phone Number*

Please enter a valid phone number.

How long did you work there? Years*

How long did you work there? Months*

Are you a relative of a current Hudson County Schools of Technology employee?*

YesNo

If yes, please specify employee’s name and relationship*

Are you a relative of a Hudson County Schools of Technology Board Member?*

YesNo

If yes, please specify Board Member’s name and relationship*

Would you like to upload a resume?*

Resume Upload*

Would you like to upload a cover letter?*

Cover Letter Upload

Signature*

Date*

Date

NONDISCRIMINATION NOTICE

“IT IS THE POLICY OF THE BOARD OF EDUCATION OF THE HUDSON COUNTY SCHOOLS OF TECHNOLOGY NOT TO DISCRIMINATE IN EMPLOYMENT OR EDUCATIONAL OPPORTUNITY AGAINST ANY PERSON BY REASON OF RACE, COLOR, NATIONAL ORIGIN, ANCESTRY, AGE, SEX, AFFECTIONAL OR SEXUAL ORIENTATION, MARITAL STATUS, LIABILITY FOR SERVICE IN THE ARMED FORCES OF THE UNITED STATES, OR ATYPICAL HEREDITARY CELLULAR OR BLOOD TRAIT OF ANY INDIVIDUAL, IN EMPLOYMENT OR IN EDUCATIONAL OPPORTUNITIES. FURTHER STATE AND FEDERAL PROTECTION IS EXTENDED ON ACCOUNT OF DISABILITIES, SOCIAL OR ECONOMIC STATUS, PREGNANCY, CHILDBIRTH, PREGNANCY RELATED DISABILITIES, ACTUAL OR POTENTIAL PARENTHOOD, OR FAMILY STATUS.” Inquiries regarding affirmative action, discrimination (including Title IX requirements), sexual harassment or equity should be directed to: Alicia Abraham, Affirmative Action Officer/504 Officer/Title IX Coordinator, Hudson County Schools of Technology, Earl W. Byrd Center, Explore Middle School, Frank J. Gargiulo Campus, One High Tech Way, Secaucus, NJ 07094, 201-662-6724 or Email: aabraham@hcstonline.org or dthompso@hcstonline.org

NON-INSTRUCTIONAL APPLICATION

APPLICANT'S INFORMATION

BUS DRIVER POSITION

CRIMINAL RECORD CHECK

NEW JERSEY'S PENSION SYSTEM

EDUCATION AND TRAINING

MILITARY TRAINING/EXPERIENCE

SPECIFIC SKILLS

PROFESSIONAL REFERENCES

CURRENT OR PAST EMPLOYER INFORMATION

RELATION TO HCST EMPLOYEE OR BOARD MEMBER

RESUME AND COVER LETTER

I CERTIFY THAT THE INFORMATION PROVIDED IN THIS APPLICATION IS TRUE AND CORRECT: