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-- - JUDICIAL BRANCH OF ILLINOIS An Equal (Illinois)

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APPLICATION FOR EMPLOYMENT
JUDICIAL BRANCH OF ILLINOIS An Equal Opportunity Employer
Administrative Office of the Illinois Courts
3101 Old Jacksonville Road
THE JUDICIAL BRANCH HAS RECRUITMENT AND EMPLOYMENT
Springfield, Illinois 62704
POLICIES SEPARATE FROM THE LEGISLATIVE AND EXECUTIVE
Phone: (217) 524-6429
BRANCHES OF STATE GOVERNMENT.
TDD: (217) 524-6428
PLEASE TYPE OR PRINT IN INK. ANSWER ALL ITEMS FULLY OR INDICATE “N/A” IF NOT APPLICABLE. PLEASE
ATTACH ADDITIONAL SHEETS IF MORE SPACE IS NEEDED. THE ATTACHMENT OF A RESUME WILL NOT BE
ACCEPTED AS A SUBSTITUTE FOR RESPONSES TO ANY SECTION OF THIS APPLICATION.
PRINT NAME:
LAST
FIRST
MIDDLE
PRESENT STREET ADDRESS:
CITY
STATE
ZIP CODE
TITLE OF POSITION DESIRED
AREA CODES AND TELEPHONE NUMBERS:
MINIMUM ACCEPTABLE ANNUAL SALARY
DAY: ( ) EVENING: ( )
YES NO
HAVE YOU BEEN PREVIOUSLY EMPLOYED BY THE JUDICIAL BRANCH OF GOVERNMENT IN ILLINOIS?
IF YES, GIVE JOB TITLE, LOCATION AND DATES OF EMPLOYMENT:
YES *
NO
HAVE YOU EVER BEEN CONVICTED OF A FELONY?
IF YES, GIVE DETAILS:
HOW WERE YOU REFERRED TO THIS OFFICE? _______________________________________________________________________________
YES **
NO
ARE YOU CURRENTLY IN DEFAULT ON THE REPAYMENT OF ANY EDUCATIONAL LOANS?
YES NO
DO YOU HAVE A CHILD SUPPORT OBLIGATION UNDER A COURT OR ADMINISTRATIVE ORDER?
YES NO
ARE YOU LAWFULLY ENTITLED TO WORK IN THE UNITED STATES?
PROOF OF CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT
NO
HAVE YOU EVER APPLIED FOR EMPLOYMENT WITH THE JUDICIAL BRANCH IN THE PAST? YES
IF YES, GIVE DATE AND POSITION TITLE:
YES NO
ARE YOU CURRENTLY EMPLOYED?
NO
YES***
MAY WE CONTACT YOUR PRESENT EMPLOYER?
ON WHAT DATE WOULD YOU BE AVAILABLE TO BEGIN WORK? _______________________________________
ARE YOU AVAILABLE TO WORK: FULL TIME
□ PART TIME □ TEMPORARY □
YES
NO
CAN YOU TRAVEL IF THE JOB REQUIRES IT?
NO
YES
ARE YOU RELATED TO A CURRENT EMPLOYEE OF THE JUDICIAL BRANCH?
IF SO, GIVE NAME OF EMPLOYEE:
*
PURSUANT TO 705 ILCS 405/5-915, APPLICANTS ARE NOT OBLIGATED TO DISCLOSE EXPUNGED JUVENILE RECORDS OF ADJUDICATION,
ARREST, OR CONVICTION.
** 5 ILCS 385/1 ET SEQ. PROVIDES THAT PERSONS WHO ARE IN DEFAULT OF AN EDUCATION LOAN FOR A PERIOD OF 6 MONTHS OR
MORE AND IN AN AMOUNT OF $600.00 OR MORE SHALL MAKE LOAN REPAYMENT ARRANGEMENTS WITH THE MAKER OR GUARANTOR
OF THE LOAN AS A CONDITION OF EMPLOYMENT.
*** BY SELECTING 'YES,' I AM GRANTING AOIC STAFF PERMISSION TO CONTACT MY EMPLOYER AT ANY POINT DURING THE RECRUITMENT PROCESS.
(08/19) PAGE 1 OF 4
I I
I I
I I
EXPERIENCE
LIST YOUR CURRENT OR MOST RECENT JOB AND WORK BACKWARDS, DESCRIBING EACH JOB YOU HAVE HELD. IF YOU HAVE HAD MORE THAN THREE
EMPLOYERS, MAKE A COPY OF THIS PAGE BEFORE YOU BEGIN, INDICATE REASONS FOR ANY GAPS IN EMPLOYMENT HISTORY IF YOU HELD DIFFERENT JOBS
WITH THE SAME EMPLOYER, LIST EACH JOB SEPARATELY.
NAME AND ADDRESS OF EMPLOYER’S ORGANIZATION (INCLUDE ZIP CODE, IF KNOWN)
DATES EMPLOYED (MONTH, DATE AND YEAR)
FROM: TO:
YOU SUPERVISED
EXACT TITLE OF YOUR JOB
YOUR IMMEDIATE SUPERVISOR (NAME):
AREA CODE
TELEPHONE NUMBER
YOUR REASON FOR LEAVING
DESCRIPTION OF WORK: DESCRIBE YOUR SPECIFIC DUTIES, RESPONSIBILITIES AND ACCOMPLISHMENTS IN THIS JOB. IF YOU DESCRIBE MORE THAN ONE TYPE OF WORK (FOR EXAMPLE,
CARPENTRY AND PAINTING, OR PERSONNEL AND BUDGET), WRITE THE APPROXIMATE PERCENTAGE OF TIME YOU SPENT DOING EACH. (DO NOT WRITE “SEE RESUME”)
LIST YOUR CURRENT OR MOST RECENT JOB AND WORK BACKWARDS, DESCRIBING EACH JOB YOU HAVE HELD. IF YOU HAVE HAD MORE THAN THREE
EMPLOYERS, MAKE A COPY OF THIS PAGE BEFORE YOU BEGIN, INDICATE REASONS FOR ANY GAPS IN EMPLOYMENT HISTORY IF YOU HELD DIFFERENT JOBS
WITH THE SAME EMPLOYER, LIST EACH JOB SEPARATELY.
NAME AND ADDRESS OF EMPLOYER’S ORGANIZATION (INCLUDE ZIP CODE, IF KNOWN)
DATES EMPLOYED (MONTH, DATE AND YEAR)
FROM: TO:
YOU SUPERVISED
EXACT TITLE OF YOUR JOB
YOUR IMMEDIATE SUPERVISOR (NAME):
AREA CODE
TELEPHONE NUMBER
YOUR REASON FOR LEAVING
DESCRIPTION OF WORK: DESCRIBE YOUR SPECIFIC DUTIES, RESPONSIBILITIES AND ACCOMPLISHMENTS IN THIS JOB. IF YOU DESCRIBE MORE THAN ONE TYPE OF WORK (FOR EXAMPLE,
CARPENTRY AND PAINTING, OR PERSONNEL AND BUDGET), WRITE THE APPROXIMATE PERCENTAGE OF TIME YOU SPENT DOING EACH. (DO NOT WRITE “SEE RESUME”)
LIST YOUR CURRENT OR MOST RECENT JOB AND WORK BACKWARDS, DESCRIBING EACH JOB YOU HAVE HELD. IF YOU HAVE HAD MORE THAN THREE
EMPLOYERS, MAKE A COPY OF THIS PAGE BEFORE YOU BEGIN, INDICATE REASONS FOR ANY GAPS IN EMPLOYMENT HISTORY IF YOU HELD DIFFERENT JOBS
WITH THE SAME EMPLOYER, LIST EACH JOB SEPARATELY.
NAME AND ADDRESS OF EMPLOYER’S ORGANIZATION (INCLUDE ZIP CODE, IF KNOWN)
DATES EMPLOYED (MONTH, DATE AND YEAR)
FROM: TO:
YOU SUPERVISED
EXACT TITLE OF YOUR JOB
YOUR IMMEDIATE SUPERVISOR (NAME):
AREA CODE
TELEPHONE NUMBER
YOUR REASON FOR LEAVING
DESCRIPTION OF WORK: DESCRIBE YOUR SPECIFIC DUTIES, RESPONSIBILITIES AND ACCOMPLISHMENTS IN THIS JOB. IF YOU DESCRIBE MORE THAN ONE TYPE OF WORK (FOR EXAMPLE,
CARPENTRY AND PAINTING, OR PERSONNEL AND BUDGET), WRITE THE APPROXIMATE PERCENTAGE OF TIME YOU SPENT DOING EACH. (DO NOT WRITE “SEE RESUME”)
(08/19) PAGE 2 OF 4
EDUCATION
NAME AND ADDRESS
OF SCHOOL COURSE OF STUDY
YEARS
COMPLETED
DIPLOMA/
DEGREE
HIGH
SCHOOL
UNDERGRADUATE
COLLEGE
GRADUATE/
PROFESSIONAL
OTHER
(SPECIFY)
DESCRIBE ANY ADDITIONAL SPECIALIZED TRAINING, APPRENTICESHIP AND SKILLS THAT ARE WORK RELATED
STATE ANY ADDITIONAL INFORMATION YOU FEEL MAY BE HELPFUL IN CONSIDERING YOUR APPLICATION
LEVEL OF PROFICIENCY (PLEASE CHECK)
ABOVE LITTLE OR NO SKILL
SPECIALIZED SKILLS
AVERAGE
AVERAGE
OR TRAINING
PERSONAL COMPUTER
CALCULATOR
MULTI-LINE TELEPHONE
COPIER/FAX MACHINE
PLEASE LIST PERSONAL COMPUTER SOFTWARE YOU HAVE USED ON THE JOB AND/OR HAVE TRAINING IN AND
INDICATE PROFICIENCY USING THE SCALE ABOVE.
(08/19) PAGE 3 OF 4
PLEASE LIST THREE PERSONS, NOT RELATED TO YOU, WHO HAVE DEFINITE KNOWLEDGE OF YOUR WORK
QUALIFICATIONS. DO NOT INCLUDE NAMES OF SUPERVISORS PREVIOUSLY LISTED.
FULL NAME RELATIONSHIP
TELEPHONE NUMBER
FULL NAME
RELATIONSHIP
TELEPHONE NUMBER
FULL NAME
RELATIONSHIP
TELEPHONE NUMBER
PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING THIS APPLICATION
I CERTIFY THAT THE STATEMENTS MADE BY ME IN THIS APPLICATION, ARE CORRECT, COMPLETE AND TRUE
TO THE BEST OF MY KNOWLEDGE AND ARE MADE IN GOOD FAITH. I UNDERSTAND THAT ANY FALSE
STATEMENTS MADE HEREIN WILL VOID THIS APPLICATION AND CAN, IF HIRED, RESULT IN TERMINATION OF
MY EMPLOYMENT.
I AUTHORIZE THE JUDICIAL BRANCH OFFICE TO WHICH I AM APPLYING TO INVESTIGATE ALL STATEMENTS
CONTAINED IN THIS APPLICATION. I FURTHER AUTHORIZE THAT OFFICE TO SECURE ANY INFORMATION FROM
ALL MY EMPLOYERS, REFERENCES, AND ACADEMIC INSTITUTIONS WHICH MAY BE RELEVANT TO AN
EMPLOYMENT DECISION. I HEREBY RELEASE ALL OF THOSE EMPLOYERS, REFERENCES, AND ACADEMIC
INSTITUTIONS AND THE JUDICIAL BRANCH OFFICE TO WHICH I AM APPLYING FROM ANY AND ALL LIABILITY
ARISING FROM THE GIVING OR RECEIVING OF SUCH INFORMATION.
I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD, AND THAT I MAY
BE TERMINATED, WITH OR WITHOUT A REASON, AT ANY TIME AND WITHOUT PRIOR NOTICE.
SIGNATURE OF APPLICANT x DATE
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. WE DO NOT DISCRIMINATE ON THE BASIS OF RACE,
RELIGION, COLOR, SEX, AGE, NATIONAL ORIGIN OR DISABILITY.
(08/19) PAGE 4 OF 4
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Completed 4 December 2020

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