CERTIFIED (TEACHER) APPLICATION
Teacher (Word
Document) Application Link
APPLICATION FORM
FOR
TEACHING POSITION
WITH
UNIFIED SCHOOL DISTRICT #247
506 SOUTH SMELTER
CHEROKEE, KS 66724
USD #247, Cherokee, KS, does not discriminate on the bases of race, color, national origin, sex, handicap, or age in admission or access to, or treatment of employment in, its programs or activities. Any questions regarding compliance with Title VI, Title IX, or Section 504 may contact at the above address:
Tim Burns, 620-457-8350 (Title IX Coordinator or Section 504 Coordinator)
Name: ____________________________________________________________
Last First Middle
Mailing Address: ____________________________________________________
Phone: _______________________
Date of Candidate’s Availability: ________________________________________
Date of Application: ____________________
Apply for teaching position in: K-6 _____ 7-8 _____ 9-12 _____
Rank your preference regarding subject(s) you wish to teach:
1. __________ 2. __________ 3. __________ 4. __________
Extra curricular activities you wish to direct: _____________________________
PERSONAL
DATA
1.
Is there any position(s) for which you should not be considered or
job duties
you can not perform?
_____________________________________________
________________________________________________________________
2.
Do you have any contagious or communicable diseases which may
endanger
others?
_________________________________________________
3. Have you even been convicted of a felony? Yes ____ No _____
4. Are you a citizen of the
U.S.A.? _____ If
not, are you an alien lawfully
authorized to work in the
United States? _____
EDUCATIONAL DATA
1. High School Attended:
2. College Training in
Chronological Order:
School
Attended
&
Inclusive
Degree (and
Major Minor
Location
Dates
/or)
Hours
Field Field
3. Number of Semester Hours since
attaining your last degree:
Undergraduate
Graduate
.
4. College Honors and Activities:
PROFESSIONAL DATA
1. Current Employment:
2. Are you now under
contract?
If so, when does your contractual
obligation
expire?
3. Do you currently hold, or are you qualified for a teaching certificate in Kansas?
Yes No
If so, state:
a. Issue and Expiration Dates:
b. Endorsements on Certificate:
4. Chronological Teaching
Record:
School Name and Location
Teaching
Duties
Dates
Monthly
Salary
 |
|
 |
5. Professional Memberships:
6. College Placement Bureau where your credentials are
available:
7. List the names and address of your past two
immediate
supervisors:
Name Position Address and Telephone Number
8. Other Work Experience:
Employer and Location Duties Date of Employment
ADDITIONAL DATA
1. State briefly your reasons for
wishing to be a teacher in our district.
2. Please mention here anything
not included elsewhere in This application which you feel will
further support your
candidacy.
APPLICANTS JOBB APPLICATION ACKNOWLEDGEMENTS
1.
I CERTIFY THAT ALL THE INFORMATION PROVIDED BY ME IN
THIS
APPLICATION
IS TRUE AND COMPLETE. I UNDERSTAND THAT ANY
MISSTATEMENT,
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
YOUR. I AUTHORIZE ANY BACKGROUND CHECKS BY ANY THIRD
PART.
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.
Signature of Applicant: Date:
________________________________ __________________
ATTACHMENTS
Resume
Letter of Application
Kansas Teaching Certificate
Transcript
References
