1 2 3 4 5 6 7 8 9 Page 1 of 9 Name: Address: Primary Phone: Secondary Phone (if applicable): Email: Are you at least 18 years of age? Yes No Do you have access to reliable transportation to travel to work? Yes No Do you have a valid driver's license? Yes No NOTE: In order to complete the application process, you must submit a copy of your driving record. Wisconsin: You may obtain a copy of your driving record from the Wisconsin DOT (link opens in a new window/tab). Other States: Please contact your state's Dept. of Transportation to obtain a copy of your driving record. Please note: You may fax your driving record to the South Central Library System at (608) 266-4881. Note, if hired you will be required to obtain a regular Wisconsin Driver’s License. As a matter of policy and in accordance with applicable state and local law, SCLS does not use or consider pending criminal charges or criminal convictions in making hiring decisions unless the circumstances of the pending charge or conviction are substantially related to the circumstances of the particular job of the individual is not bondable under a standard fidelity or an equivalent bond when bondability is required for the particular job. If there are extenuating circumstances of which you believe SCLS should be aware, please state below Leave this field blank Next Page >
