Application printed from the Education America Network Name: SS# THE SCHOOL DISTRICT OF MARTIN COUNTY, FLORIDA Application for Instructional/Administrative Position Division of Human Resources 500 East Ocean Boulevard Stuart, Florida 34994 Applicants for positions with the Martin County School Board should complete this application in its entirety, including a copy of your Florida Educator s Certificate, if required for the position. If you do not have a Florida teaching certificate but have applied for one, include a copy of the postcard receipt, official statement or any other correspondence from the Florida Department of Education. If you have not applied for a Florida Educator s Certificate, indicate such on the application. Form #62B Page 1 of 10 P E R S O N A L (Please Print) Name Social Security Number: Application Date Present Address: Permanent Address: Phone: ( ) Alternate Phone: ( ) E-mail Address
Check positions for which you are applying in order of preference by sequence (1, 2, 3, etc.) Form #62B Page 2 of 10 Full-Time Pre-K and/or Kindergarten Exceptional Student Education Part-Time Elementary (Grades 1 3) V.A..C.E. (Specify area) Substitute Elementary (Grades 4 5) For V.A.C.E. or grades 7-12, list Middle (Grades 6 8) Senior High (grades 9-12) preference of subjects. Have you ever been employed by the School Board of Martin County? Yes No If yes, what position(s): Location(s) Have you ever worked for the School Board of Martin County under a different name? Yes No If yes, name: Is there any additional information necessary, relative to a change in name or use of an assumed name or a nickname, which would enable us to check on your background? Yes No If yes, explain: When are you available to start work? Are you under contract to any school system at the present time? Yes No If yes, name of school system: Are you a U.S. citizen? Yes No If no, VISA type: E D U C College/ University 1 Name and Location of School Course of Study No. of Years completed Did you Graduate? Date Yes No Date Degree/ Diploma A T I 2 Yes Date No O N Yes No 3 Date
Form #62B Page 3 of 10 The School Board of Martin County is required by law to conduct a criminal background check on every new employee. Please note that disclosure of prior criminal history will not automatically bar employment. However, if this section is not truthfully completed, you may be recommended for dismissal from employment, regardless of when falsification is determined. If you have any questions regarding this section, please ask anyone in the Personnel Office for assistance. ARREST / REVOCATION RECORD YES NO Have you ever been convicted, found guilty, entered a plea of nolo contendere (no contest), or had adjudication withheld in a criminal offense other than a minor traffic violation (DUI is NOT a minor traffic violation); or are there any criminal charges now pending against you? SEALED or EXPUNGED records must be reported pursuant to s.943.058, F.S. Failure to answer this question accurately could cause denial of employment. A YES or NO answer is required by Florida Law. If you check the YES box, you must give the information requested for each charge. Please attach a separate sheet if you need more space. City Where Arrested State Date of Arrest Charge(s) Disposition(s) YES NO Have you ever had a teaching certificate revoked, suspended, or denied by any state; or is there any action pending against your certificate or application in any state? (A determination of academic ineligibility is not considered denial of a certificate.) If YES, you must give the state where your certificate was revoked, suspended, denied, or where action is pending against your certificate or application. YES NO Have you ever been convicted of a crime or received a penalty from a judge or another law enforcement agency? Has a penalty or conviction ever been withheld or delayed or has probation been required as the result of your being arrested? Do you currently have charges pending as a result of an arrest? Has your driver s license ever been suspended or revoked? Have you been found guilty of a traffic violation or infraction in the past five years? Do you have a valid Florida Driver s License? Number: Do you have any points assessed against your license(s) at the present time? Number of points: What is the employment status with your last or current employer: Employed Resigned Terminated On Leave Suspended Laid-Off Do you hold a Florida Educator s Certificate If yes, list areas of certification: CERTIFICATION YES NO If not, have you applied for Florida certification? Do you hold a valid Educator s Certificate from another state? If yes, list areas of certification: Have you ever had a teacher s certificate from any state suspended, revoked or placed on probation? If you are an experienced teacher, what is your contract status with your last or current employer? Employed Resigned Terminated On Leave Suspended Non-renewed
NON-TEACHING EMPLOYMENT HISTORY Form #62B Page 5 of 10 Please give accurate, complete, full-time EMPLOYMENT HISTORY (excluding the teaching experience as listed previously) FOR THE PAST THREE YEARS (including self-employment, military, teacher aide, substitute teaching, industry, and unemployed periods of time). Attach additional pages if necessary. Company Name Address Telephone ( ) Employment Dates From To 1 Name of Supervisor Salary State Job Title and Describe Your Work Reason for Leaving Company Name Address Telephone ( ) Employment Dates From To 2 Name of Supervisor Salary State Job Title and Describe Your Work Reason for Leaving Company Name Address Telephone ( ) Employment Dates From To 3 Name of Supervisor Salary State Job Title and Describe Your Work Reason for Leaving MILITARY SERVICE Did you serve in the U.S. Armed Forces? No Yes If yes, list the beginning and ending dates of active duty and date of discharge VETERANS PREFERENCE (in accordance with Ch. 5 A-7, Fla. Admin. Code, and Ch. 295, Fla. Stat.) Check the appropriate space if you are claiming veterans preference. Documentation substantiating your claim must be submitted at the time of application. 1. A veteran with a compensable service-connected disability, or 2. The spouse of a veteran who cannot qualify for employment because of a total and permanent service-connected disability or the spouse of a veteran missing in action, captured or forcibly detained by a foreign power, or 3. A veteran who has served on active duty for one day or more during wartime period (excluding active duty for training) and who was discharged under honorable conditions, or 4. The unremarried spouse of a veteran who died of a service-connected disability. Have you ever claimed and been employed through veterans preference? No Yes If yes, give the name and address of the employer: Do you wish to claim veterans preference at this time? No Yes If yes, attach appropriate documentation. All documents must clearly indicate that they are copies of originals. A veterans preference statement of document/eligibility is posted in the Personnel office; a copy is available upon request. (Note: Under Florida law, preference in appointment shall be given by the State and its political subdivisions first to those persons included in 1 and 2 above, and second to those persons included in 3 and 4 above. If any applicant claiming veterans preference for a vacant position is not selected for the position, he/she may file a complaint with the Florida Department of Veterans Affairs, P.O. Box 31003, St. Petersburg, FL 33731, within 21 days after receiving notice of the hiring decision or within three months of the date the application is filed if no notice is given and the position has been filled.)
Form #62B Page 8 of 10 IMPORTANT INFORMATION CONCERNING EMPLOYMENT IN THE MARTIN COUNTY SCHOOL SYSTEM Division of Human Resources/Personnel Office 500 East Ocean Boulevard Stuart, Florida 34994 Voice Phone...(772) 219-1200, extension 30242 Job Hot Line..(772) 219-1200, extension 3 Facsimile...(772) 219-1230 Please read carefully. Receipt of the application acknowledges your request for employment with the Martin County School System. Your application will be placed on file for two years. After two years, this application will expire and it will be destroyed. If you wish to be considered for employment after the expiration of your application, you must complete a new application form. The information requested on this form is needed to evaluate your application for employment with the School Board of Martin County. All questions on the form must be answered. Incomplete applications will not be accepted. All employment offered by the School Board of Martin County, unless reflected in a written contract signed by an authorized company official, is employment-at-will. This means the employment relationship may be severed at any time, for any reason, with or without cause, by either party, whenever the severing party deems it to be in his/her/its best interest. Applicants are responsible for: 1. Guaranteeing complete accuracy of the application in its entirety. Failure to truthfully complete this application may result in a recommendation for dismissal, regardless of when falsification is determined. 2. Notifying the Personnel Office immediately of any change in employment/application status including changes of address or phone number. 3. Listing the names and complete addresses of at least three professional references. If you have teaching experience include the names of your former principals. It is the applicant s responsibility to mail the three reference forms to the designated references. 4. Acquiring and submitting official transcripts to complete the application packet. Procedures for filling vacancies include: 1. Applicants complete an application for employment in its entirety and provide all requested information. 2. Applicants may be selected for screening interviews on the basis of their qualifications and district needs. If you are selected for a screening interview you will be contacted by the Personnel Office to schedule an appointment. 3. In order to acquire a teaching position in Martin County, you must hold a valid Florida Educator s Certificate or show proof of application for the certificate. 4. To find out about advertised vacancies, applicants may contact the Job Hot Line at (772) 219-1200, extension 3. To apply for a specific advertised vacancy, you may call or write to the contact person indicated in the vacancy announcement. A completed application must be on file prior to any offer of employment.
Form #62B Page 9 of 10 Payment for Experience: Applicants who are recommended for employment are responsible for verifying previous acceptable teaching experience. In order to be granted previous teaching experience, the applicant must have held a teaching position, under contract, and the position must have required a teaching certificate issued by the state in which the teacher taught. Verification forms may be obtained from the Personnel Office. Teachers will be paid the beginning teacher s salary until verification of acceptable previous experience and/or advanced degrees have been received and approved by the Director of Personnel. Retroactive payments are normally made from the start date (in current fiscal year only). Salaries are based on training and experience. For instructional personnel, all teaching experience for in-state or out-of-state schools may be accepted. A year s credit is based upon completion of more than one-half of the number of days in the normal school year. Substitute Teacher Information: Applicants for substitute teacher positions should complete the instructional application. Applicants may apply for both regular teaching positions and substitute positions using the same application. NON-DISCRIMINATION NOTICE The School Board of Martin County complies with and fully supports the Americans With Disabilities Act. A reasonable accommodation will be made to any impairment an applicant might have that would make it difficult for that applicant to apply for employment. Each applicant will be evaluated on the basis of his/her ability, and no one asking for such an accommodation will be discriminated against in any way. It is the policy of the School Board of Martin County not to discriminate on the basis of religion, race, national origin, color, sex, age, marital status, parental status, or handicap. Discrimination is prohibited in the recruiting, hiring, assigning, promoting, paying, demoting or the dismissing of employees of the School Board of Martin County. Applicants for employment who feel they have been discriminated against may follow the grievance procedure listed in the School Board of Martin County Rule 6Gx43-1.19. It is the policy of the School Board of Martin County to provide a workplace free from tensions created by harassing remarks about one s ethnic background, religion, race, sex, marital status, age, or disability. A separate policy on harassment restates that no harassment will be tolerated in this company. Anyone engaging in harassment in violation of this policy will be subject to severe disciplinary measures up to, and including, termination for the first offense. Violations of this policy should be immediately reported to your supervisor or the Director of Personnel. No one will be retaliated against for reporting a violation of this policy or for exercising any other rights accorded by law. AGREEMENT I certify that I have answered each and every section of this application truthfully and completely. I understand that any incomplete or false information on this application may be just cause for rejection of my application for employment or dismissal in the event this application results in my employment. If employed, I agree to abide by the rules and regulations as set forth by the School Board of Martin County as necessary to the proper conduct of its business. Signed Date
THE SCHOOL DISTRICT OF MARTIN COUNTY, FLORIDA The Application Process SS.1012.56(1) and (2)(a-f), Florida Statutes; Chapter6A-4.0012, 6A-4.002, and 6A-4.003, FAC Form #62B Page 10 of 10 A completed application for initial certification consists of the following: Application Form (CG-10) MUST be filled out completely to be considered acceptable. Required sections for each application are: o Name, address, citizenship and birth date information o o Type of certificate and subject(s) requested Criminal History, Sealed, Expunged, and Revocation sections. A yes or no answer is required for each question for the application section to be considered complete. Additionally, if a yes answer is indicated, the boxes below that question requesting information about the record must be completed for the application form to be considered complete. Records previously cleared by Professional Practices Services must still be reported on each application submitted. o Character References must be completed for each application o Notary Processing fees are $56.00 per subject and/or endorsement requested for the initial certificate whether the first certificate is Temporary or Professional. More than one subject may be requested per initial application form. o If an applicant has held a Temporary Certificate and is applying for the initial Professional Certificate without a break in continuity, then only one fee is required to show all subjects on the Professional Certificate which were also shown on the Temporary Certificate. Official transcripts that reflect a bachelor s or higher degree from an accredited or approved institution. o o At least one official transcript reflecting a bachelor s or higher degree is required to complete the application (to prevent the system from sending an automatic return letter). However, additional information may be requested by the processing specialist if there are transcripts missing from the file which the applicant has listed as degrees or credits necessary for determining eligibility for the subject(s) requested. Therefore, it is advisable that all official transcripts reflecting earned college credit be submitted at the time of application. The official transcript used to complete the application must reflect the conferral date and the degree awarded. Notes: 1. If the required application sections are not completed, or if any of the items are not present, your application form will not be processed. A processing specialist will not review the file until all of the items have been received. 2. Copies (front and back) of valid out-of-state certificates should be included with the application form. If the certificates(s) is not included, it will not delay processing of the file, but may delay full determination of eligibility for a Florida certificate. **** IMPORTANT - CONTINUOUS EMPLOYMENT INFORMATION **** While your Temporary Certificate is valid for 3 school fiscal years you must demonstrate mastery of general knowledge by the achievement of passing scores on the Florida General Knowledge Test (GK) WITHIN ONE (1) CALENDAR YEAR OF THE DATE OF EMPLOYMENT. Individuals who are employed under contract at the end of the one (1) calendar year time period may continue to be employed through the end of the school year in which they have been contracted. Under the Florida Statutes, a school district shall not employ, or continue the employment of, an individual in a position for which a temporary certificate is required beyond this one (1) year time period if the individual has not passed the Florida General Knowledge Test. Received by Date
THE SCHOOL DISTRICT OF MARTIN COUNTY, FLORIDA EMPLOYMENT INFORMATION FOR HIRING MARTIN COUNTY SCHOOL BOARD EMPLOYEES This list is provided to assist you in the employment process. Please note that in addition to the many federal and state requirements, the Martin County School Board must also follow the Collective Bargaining Agreements when staffing positions. For any additional assistance, please call the Personnel office, 772-219-1200, extension 30242. 1. All available positions are listed in the Personnel Office. 2. There is a Job Hot Line that you may call for available positions twenty-four hours a day. The phone number is 772-219-1200, extension 3. You may also visit our web site www.sbmc.org/ to view available positions in Martin County. 3. You must complete an employment application that may be obtained in the Personnel Office. 4. You will also need to obtain three reference forms. Please send these to your references to be completed and returned to the Personnel Office. 5. If you have any questions regarding certification, a Certification and Retirement Specialist is available in the Personnel Office to assist you. 6. The Martin County School District requires that all new employees submit to a preemployment drug test and an FDLE background check. The cost of these is as follows: Drug Test $26.50 (Money Order payable to Martin County School Board) Drug Test for Bus Operators $34.00 (Money Order payable to Martin County School Board) FDLE Background Check $60.00 (Money Order payable to Fingerprinting Services, LLC - or - you may pay with a CREDIT CARD by calling 877-357- 7456 or via the internet at http://www.flprints.com) 7. Veterans are requested to complete a Veterans Preference Attachment.