Certified Staff Application
Position Applying for
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Last Name
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First Name
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Middle Initial
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Address Info.
Address
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City
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State / Province / Region
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Current Employment Information
Employer
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Position
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Salary
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Reason for Leaving
Prior Employment Information
Employer
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Position
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Reason for Leaving
Employer
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Position
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Reason for Leaving
Employer
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Position
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Reason for Leaving
Educational Information Please list your high school and college education in chronological order.
High School
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Graduation Year
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College
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Location
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Graduation Year
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Degree and/or Hours
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Major
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Minor
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Workshops or Seminars
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College
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Location
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Graduation Year
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Degree and/or Hours
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Major
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Minor
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Workshops or Seminars
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College
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Location
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Graduation Year
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Degree and/or Hours
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Major
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Minor
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Workshops or Seminars
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Certification Information
If so, what kind of certificate?
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When was your certificate issued?
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When does your certification expire?
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Professional honors and community activities:
Professional memberships revelant to position applied for:
Personal Information
If yes, please explain:
What is your educational philosophy?
Explain your thoughts as it relates to curriculum and instruction.
Briefly explain how you evaluate student performance.
What are your thoughts of integrating technology into classroom instruction?
If elected to this position, one of your responsibilities will be to be accountable for student performance. How would you do this?
State briefly your reasons for wishing to be an employee in our district.
Please mention here anything not included elsewhere in this application which you feel will further support your candidacy.
References Please list three people who may be contacted to give current information on your qualifications to this position
Reference #1
Name
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Position
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Address Info.
Address
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City
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State / Province / Region
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Relationship
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Years Known
Reference #2
Name
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Position
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Address Info.
Address
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City
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State / Province / Region
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Relationship
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Years Known
Reference #3
Name
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Position
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Address Info.
Address
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City
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State / Province / Region
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Relationship
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Years Known
Resume
Acknowledgments
1. I certify that all the information provided by me in this application is true and complete. I understand that any mistatement, falsification, or omission of information is grounds for refusal to hire or, if I am hired and the same is discovered thereafter, termination.
2. I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability for any damages that may result from furnishing such information to you. I authorize any background checks by any third party.
3. I authorize you to request, receive, and verify all information given on this application and I release you from all damages that may result from your doing so.
4. I authorize you to conduct a criminal background investigation using any and all methods necessary to successfully complete such investigation and I release you from all liability for any damages that may result from your doing so.
Electronic Signature
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Send
Required Fields