Application Form For Lunchroom Monitor Substitute (on-call/short notice)

Math and Science Academy (MSA)

An Equal Opportunity Employer

MSA does not discriminate against any employee or applicant for employment because of race, color, creed, religion, ancestry, national origin, sex, affectional preference, disability, genetic testing, age (except as required by law), marital status or status with regards to public assistance. Individuals will not be excluded from employment rights, participation in or be denied the benefits of, or be otherwise subjected to discrimination under any program, service or activity under the provisions of any and all applicable federal, state, and local laws against discrimination. MSA prohibits the harassment of any employee or job applicant.






Answer ALL questions completely - please print or type - be sure to complete all applicable pages.




Referred to MSA by (check one):



Have you ever been discharged by an employer:

If yes, please explain:



May we contact any of your references?

If no, please explain:







MSA has policies on sexual harassment and equal opportunity, policies which require employees to perform all assigned work and necessary overtime, policies requiring wage or salary deduction authorizations by employees for school property, debts or moneys not returned or repaid, an at-will employment policy, solicitation and distribution policies, and policies requiring employees to observe all standards of conduct, and policies of MSA.


ACKNOWLEDGEMENT: PLEASE READ AND SIGN (if you agree)

By my signature below, I promise that the information provided in this employment application (and in any related documentation or interview) is true and complete, and I understand that any false or misleading information or significant omissions may disqualify me from further consideration for employment, and may lead to my dismissal from employment, if discovered at a later date.

I authorize any person, school, current or prior employer named in this form (or related documents or interview) to provide MSA with any information and opinion requested by MSA in connection with my application, and I release such persons, employers, and schools from any liability in making such statements.

I understand if I am selected for an interview or given a conditional offer of employment, MSA may ask me if I have been convicted of a misdemeanor, a felony or convicted in a military court martial and, if yes, ask me to provide information regarding the same. I understand MSA may consider this information in connection with deciding whether to hire me in accordance with applicable law. (A conviction will not necessarily disqualify you from employment.)

I understand that this application does not create a contract of employment. I understand that, if hired, I am obliged to comply with any and all current and subsequently adopted MSA policies. I understand and agree that, if hired, my employment is at-will and is for no definite period of time, and may, regardless of the date of payment of wages or salary, be terminated at any time for any reason.






EEO-1 SELF-IDENTITY FORM

I understand that this application does not create a contract of employment. I understand that, if hired, I am obliged to comply with any and all current and subsequently adopted MSA policies. I understand and agree that, if hired, my employment is at-will and is for no definite period of time, and may, regardless of the date of payment of wages or salary, be terminated at any time for any reason.

Please check one:


Please indicate if you are a veteran of the U.S. military:

If you are a veteran, please indicate your veteran status:



PLEASE CHECK THE APPROPRIATE DESIGNATION - YOU MAY ONLY CHECK ONE DESIGNATION











Upload your resume (PDF, DOC, DOCX):


Upload your letter(s) of recommendation (PDF, DOC, DOCX):




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