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   Required Information
Login Information
 
 User Name     Must be at least 5 characters long
 Password     Password must meet the following requirements: Between 8 and 64 characters long, 1 capital letter, 1 number, 1 special character
 Confirm Password     Password must meet the following requirements: Between 8 and 64 characters long, 1 capital letter, 1 number, 1 special character
 
Personal Information
 
 First Name    
 Middle Name   
 Last Name    
 Address 1    
 Address 2   
 City    
 Province/State 
 Zip Code    
 Country 
  
 Email    
 Phone - Business   
 Phone - Mobile   
 Phone - Home    
 Phone - Fax   
 
Secondary Address
 
 Address 1   
 Address 2   
 City   
 Province/State   
 Zip Code   
 Country   
 
Optional Information
 
 Birth Date  Format mm/dd/yyyy
 Employee Number 
 Ethnicity 
 Gender 
 Social Security No.  Format numeric only
 
Employer Questions
 
Are you legally authorized to work in the United States?
 
 
Have you worked for WCSD before?
 
 
If yes, when and where?
 
Are you related to anyone in the WCSD?
 
 
If yes, who and what location?
 
Have you ever been dismissed or discharged from any employment?
 
 
If yes, please explain in detail.
 
Have you ever been convicted of a crime or offense?
 
 
If yes, please explain in detail.
 
Acknowledgement and Release of Information I understand that, at some point in the selection process, some or all of the information contained in this application could become public and that the facts set forth herein are subject to verification. I hereby authorize the Wasatch County School District (WCSD) to investigate my background as part of the application process. It is the intent of such authorization to provide full and free access to information for the specific purpose of pursuing a background investigation which may provide pertinent data for the WCSD to consider in determining my suitability for employment. I understand that if I am employed by the Wasatch County School District, I will be required to submit to an FBI criminal and child abuse background check. I will be required to be fingerprinted at my expense. I further understand and agree that if I have been convicted of a crime which has not been disclosed to WCSD, the District may immediately dismiss me.
 
 
I authorize any and all law enforcement agencies, current and former employers, and academic institutions to supply any information regarding my background to the Wasatch County School District, and to its agents and employees. In consideration of the WCSD's review of this employment application, I hereby release the Wasatch County School District, its employees and agents, and all providers of information from any liability resulting from such investigation or furnishing and/or receiving such information.
 
 
I have read and understand the above release statements and agree to their contents. I declare under penalties of false statement that I have examined this application and to the best of my knowledge and belief, the information contained therein is true, complete and accurate. I understand that falsification of information on this application form may be grounds for dismissal.
 
 
  
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