LEOPOLD R-III SCHOOL DISTRICT
100 Main Street
P.O. Box 39
Leopold, MO 63760-0039
Phone: 573-238-2211
Fax: 573-238-9868
APPLICATION FOR NON-CERTIFIED EMPLOYMENT
PERSONAL Date________________________
Name_______________________________________________
Address_____________________________________________ Phone No.____________________
EMPLOYMENT DESIRED
Position______________________________________________ Date you can start_____________
EDUCATION Name of School: Years Attended: Date Graduated:
High School _______________________________ ___________________ ______________
College _______________________________ ___________________ _______________
University _______________________________ ___________________ _______________
FORMER EMPLOYERS:
Month & Year:
Name, Address, Phone Number of Employer:
From___________
_____________________________________________________________
To_____________
_____________________________________________________________
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From___________
_____________________________________________________________
To _____________
_____________________________________________________________
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From___________
_____________________________________________________________
To_____________
_____________________________________________________________
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List any additional experience you may had
that may be helpful for the position desired.
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Print this application, complete it, and return
it with any additional information you desire to:
Superintendent's Office, Leopold R-III School,
P.O.Box 39, Leopold, MO 63760-0039
Equal Opportunity Employer
NON DISCRIMINATION NOTICE
Leopold R-III School District does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups. The following person has been designated to handle inquiries regarding the non-discrimination policies:
Keenan Kinder
Superintendent
100 Main Street
Leopold MO 63760
573-238-2211
For further information on notice of non-discrimination, visit http://wdcrobcolp01.ed.gov/CFAPPS/OCR/contactus.cfm for the address and phone number of the office that serves your area, or call 1-800-421-3481.