Instructional and Administrative Application
Reaquired field: Name
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Reaquired field: Present Address
Address
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City
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State / Province / Region
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Reaquired field: Birthdate
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In Case of Emergency Notify
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Relation
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If yes, please explain
References Please list four references; include superintendents and principals under whom you have worked.
Reaquired field: Reference 1 Name and Position
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Reaquired field: Reference 1 Information
Address
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City
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State / Province / Region
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Reaquired field: Reference 2 Name and Position
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Reaquired field: Reference 2 Information
Address
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City
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State / Province / Region
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Reaquired field: Reference 3 Name and Postion
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Reaquired field: Reference 3 Information
Address
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City
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State / Province / Region
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Reaquired field: Reference 4 Name and Position
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Reaquired field: Reference 4 Information
Address
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City
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State / Province / Region
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Educational and Professional Training
Reaquired field: High School, include City and State
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Reaquired field: Date Attended/Graduated
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Reaquired field: College, include City and State
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Date Attended
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Reaquired field: Graduation Date and Degree
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Total Hours
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Graduate Work
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Date Attended
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Graduation Date and Degree
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Total Hours
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Reaquired field: Undergraduate Major
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Reaquired field: Undergraduate Minor
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Graduate Major
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Graduate Area of Specialization
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Reaquired field: College activities in which you have participated
Internship
School District
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Date
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Grade/Subject Taught
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Principal
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Supervising Teacher
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Level
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Subjects qualified to teach as listed on Teaching License
List annual salary of last teaching position held
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Activities you would be willing to sponsor
By submitting this application, I agree to the following statements. I authorize investigation of all statements contained in this application. I understand misrepresentation or omission of facts is cause for dismissal without notice at any time during my employment. I agree, if employed, to follow all rules and regulations of the district. I understand, by state law, the board of education must require all employees to submit a health certificate from a physician along with a tuberculin test, at my expense. I agree to promptly notify the district of any change of address during my employment.
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Required Fields