Professional Teacher Employment Application I UNDERSTAND THAT I CANNOT BEGIN WORK AND RECEIVE COMPENSATION UNTIL MY LICENSE, BCI & FBI, AND EMPLOYEE PACKET MATERIALS ARE RECEIVED AND ACCEPTED BY HUMAN RESOURCES. Applicant Name Present Address Telephone City ST Zip E-Mail I will be moving soon Yes No If yes, my new address will be: New Address Telephone City ST Zip E-Mail Social Security Number PROFESSIONAL TEACHER CREDENTIALS: Position Requested: 1 st choice 2 nd choice 3 rd choice Certificates/Licenses Held (Circle one) ( Temporary, 2 year, 4 year, 5 year, 8 year, or permanent) Please list subject area, expiration date, and state of license and attach license to the application. National Board Certified Teacher: (Yes/No) National Teacher Exam: (Yes/No) Certificate Area Year Passed Core Passed Specialty Professional Teacher Application PA.docx 1/22/2014 Page 1
EXTRA-CURRICULAR AREAS: Please list activities/areas that you are willing and qualified to direct/supervise, including arts and recreational. EDUCATION AND TRAINING: INSTITUTION STATE DEGREE GRADUATION GPA MAJOR/MINOR High School NA NA TEACHING EXPERIENCE: INSTITUTION STATE GRADE SUBJECT AREAS WHEN DID YOU START TEACHING THERE? WHEN DID YOU END TEACHING THERE? OTHER WORK EXPERIENCE: EMPLOYER ADDRESS DATES JOB SUPV NAME PHONE NUMBER Military Service: Military Service: Yes No Branch Rank Years Professional Teacher Application PA.docx 1/22/2014 Page 2
PERSONAL REFERENCES: NAME ADDRESS RELATIONSHIP PHONE NUMBER Professional Teacher Application PA.docx 1/22/2014 Page 3
APPLICANT INFORMATION: Please complete this section in your own handwriting. If more room is needed, attach a separate sheet. If you wish, you may elaborate on any of the questions or information in this application. 1. What are your major strengths as a teacher? 2. What are you major weaknesses as a teacher? 3. What approaches do you find to be most effective in motivating students? 4. What is the most rewarding aspect of teaching for you? 5. How do you deal with difficult students and/or difficult parents? 6. What plans do you have for further professional development? PLEASE RESPOND TO ALL OF THE FOLLOWING QUESTIONS Have you continuously lived in the State of Ohio for the past five years? Yes No Have you ever been arrested in the State of Ohio or in any other state of the Union for anything other than a vehicle moving violation? Yes No If yes, please provide explanation on a separate sheet of paper. Have you ever been convicted of any felony or violation of O.R.C. 3319.39 [any offense of violence, theft, or drug abuse that is not a minor misdemeanor or a substantially comparable ordinance or statute under federal, state (in state/out of state), or municipal (in state/out of state) law? Yes No If yes, please explain: Has your teaching or employment contract ever been terminated under O.R.C. 3319.16, 3319.081, 124.34, and/or a collective bargaining agreement or a comparable federal or state law? (Termination will not necessarily disqualify applicant from employment.) Yes No If yes, please explain: Has your teaching certificate/license ever been revoked, suspended, or terminated under Ohio or any other comparable state law? (Proceedings involving your certificate/license will not necessarily disqualify applicant from employment.) Yes No If yes, please explain: Have suspension and/or termination proceedings under Ohio or comparable federal and state law ever been initiated against you? (The initiation of a proceeding will not necessarily disqualify applicant from employment.) Yes No If yes, please explain: Professional Teacher Application PA.docx 1/22/2014 Page 4
APPLICANT S STATEMENT I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I realize that I may be required to undergo a physical examination and tuberculin skin test. A reference check will be conducted which will include a criminal background check. Applicants are required to provide proof of current certification, official copies of all transcripts, and complete credentials and references, including records of prior employment. In the event of employment, I understand that false or misleading information given in my application, resume, or interviews may result in discharge. I also understand that I am to abide by all policies, rules, and regulations of the Board of Directors and administration. I understand that the Board of Directors or Education Director may wish to verify the statements I have made in this application. I hereby give my permission for Performance Academies or its authorized representative(s), either at this time or any time during my employment with the Board, to request and review any of my employment records, court records, and/or police records from any local, state, or federal agency keeping such records. The undersigned certifies that he/she has answered the above questions knowingly and truthfully to the best of his/her ability. I UNDERSTAND THAT I CANNOT BEGIN WORK AND RECEIVE COMPENSATION UNTIL MY LICENSE, BCI & FBI, AND EMPLOYEE PACKET MATERIALS ARE RECEIVED AND ACCEPTED BY HUMAN RESOURCES. Applicant Name (Print) Applicant Signature Date: Performance Academies is an equal opportunity employer and as such, is consistent with applicable federal and Ohio law, and does not discriminate on the basis of race, color, religion, gender, age, ancestry, national origin, or disability. Professional Teacher Application PA.docx 1/22/2014 Page 5