Employment Application

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

All information provided will be kept confidential and the completed application becomes the property of the Dodge City Public Library system once submitted.

Personal Information

Conviction of a crime is not an automatic bar to employment. The library will consider the nature of the offense, the date of the offense, and the relationship between the offense and the position for which you are applying.



College #1
College #2

Work History

Employment #1
Employment #2
Employment #3

References (professional or educational)

Reference #1
Reference #2
Reference #3

My signature below authorizes the library to conduct a background investigation and authorizes the release of information in connection with my application for employment. This investigation may include such information as criminal or civil convictions, driving records, previous employers and educational institutions, personal and professional references, and other appropriate sources. I waive my right to access to any such information, and without and without limitation hereby release the Library and the reference source from any liability in connection with its release or use. This release includes the sources cited above and specific examples as follows: the local Sheriff, information from the Central Criminal Records Exchange of either data on all criminal convictions or certification no date on criminal convictions are maintained, information from Kansas or other State Department of Social Services Child Protective Services Unit and any Locality to which they may refer for release of information pertaining to any findings of child abuse or neglect investigations around me.

Furthermore, I certify that I have made true, correct, and complete answers and statements on this application in the knowledge that they may be relied upon in considering my application, and I understand that any omission and/or false answered statement made by me on this application or any supplement to it will be sufficient ground for failure to employ or for my discharge would I become employed with the Dodge City Public Library. I further agree to observe all rules, regulation, and policies of the Library.

Please submit cover letter, resume, or other application materials to rebeccag@dcpl.info.

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