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School Union
#7 APPLICATION FOR SUPERINTENDENT OF SCHOOLS_________________________________________________________________________________________________________SCHOOL UNION #7 DOES
NOT DISCRIMINATE IN THE OPERATION OF ITS EDUCATIONAL AND CURRENT SCHOOL DISTRICT INFORMATION Are you presently under contact to a school system? Yes____ No____ If so, when does your contract expire?____________________________________________________________ Name of system_________________________________________________________________State________ Position_____________________________________Present Salary____________________________________ EDUCATION: Transcripts, including grades, from all college/university grades must be provided. It is essential that this section be completed accurately. College/University
Attended Degree Awarded (if any) No.
of Yrs Grade Point Average _______________________
___________________ ________ ________________ CERTIFICATION: List certification(s) you hold and provide copies of certification. Type State Date Issued Date of Expiration
_______________________________________________________________________________________ If you do not hold a Maine certificate, for what type of Maine certificate are you applying and eligible? ______________________________________________________________________________________ NOTE: Candidates who do not hold Maine certification should direct an inquiry to the Maine Department of Education, Division of Certification and Placement, Augusta, Maine 04333. EXPERIENCE: A resume must be provided. In addition to educational background and work experience, please list positions held, employer and dates of employment for the past ten years. Please account for any gaps in employment. From (Month/Year) To
(Month/Year)
Position Employer Number of years of teaching experience_________. Number of years of administrative experience__________. Have you ever been disciplined, discharged, or asked to resign from a prior position? Yes_______No________ Have you ever resigned from a prior position after a complaint had been received against you or your conduct was under investigation or review? Yes_____No_______ Has your contract in a prior position ever been non-renewed? Yes_______No_________ Have you ever not been nominated for re-employment in a prior position or ever had your nomination for re-employment not approved? Yes______No_________ Have you ever been charged with or investigated for sexual abuse or harassment of another person? Yes______No______ Have you ever been charged with, pleaded guilty or “no contest” (nolo contendere) to, or been convicted of any crime involving sexual abuse of any person or any other crime of morale turpitude? Yes_______No_________ Have you (a) ever been convicted of a crime, other than a minor traffic offense; or (b) ever entered a plea of guilty or a plea of “no contest” (nolo contendere), or has any court ever deferred, filed or dismissed proceedings without a finding of guilty and required that you pay a fine, penalty or court costs and/or imposed a requirement as to your behavior or conduct for a period of time in connection with any crime (other than a minor traffic offense?) Yes______No________ If you have answered yes to any one of the previous questions, please explain, in detail, including the date of the court action, the offense in question, and the address of the court involved. Conviction or other disposition of a crime is not necessarily an automatic bar to employment. Note: Conviction of a crime is not an automatic bar to employment by the school unit. REFERENCES: List three, two of whom are most recent supervisors, who can comment on your ability and whom we may contact. In addition, please provide three letters of reference from persons who are not related to you (may be from references listed below). Name Position Address Phone
_________________________________________________________________________________________ MEMBERSHIPS IN PROFESSIONAL ORGANIZATIONS OTHER RELEVANT WORK EXPERIENCE AND ACHIEVEMENTS CIVIC AND COMMUNITY INVOLVEMENT WHERE DID YOU LEARN OF THIS POSITION? _____www.ServingSchools.com _____Journal Tribune ____Portland Press Herald ____Friend _____Other, please specify________________________________ My signature below constitutes authorization to check my employment history, including without limitation, criminal arrest and conviction record checks, reference checks, and release of investigatory information possessed by any state, local or federal agency. I further authorize those persons, agencies or entities that School Union #7 contacts in connection with my employment application to fully provide School Union #7 any information on the matters set forth above. I expressly waive in connection with any request for or provision of such information, any claims, including without limitation, defamation, emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against School Union #7, its agents and officials or against any provider of such information. I understand that information submitted in and with this application may be disclosed to a screening and/or interviewing committee, which may include Board members, administrators, other staff, and members of the community. I give my consent to this disclosure. ______________________________. ___________________. Signature Date
APPLICATION FOR ADMINISTRATIVE POSITION CHECKLIST: The completed employment application cannot be evaluated unless all of the following materials have been provided:
________ Application form fully completed ________ Copies of Transcript(s) ________ Copy of Maine Certification(s) ________ Resume ________ Gaps in employment during the past ten years explained ________ YES to any of the questions in the Background section explained ________ Three letters of reference ________ Application signed
NOTE: ALL APPLICATION MATERIALS BECOME THE PROPERTY OF SCHOOL UNION #7. NONE WILL BE RETURNED. PROVIDING ANY FALSE OR MISLEADING INFORMATION ON THIS APPLICATION OR IN THE APPLICATION OR EMPLOYMENT SCREEING PROCESS SHALL BE FULLY SUFFICIENT GROUNDS TO REFUSE TO EMPLOY THE APPLICANT OR, IF THE APPLICANT HAS BEEN EMPLOYED, TO IMMEDIATELY DISMISS THE APPLICANT/EMPLOYEE.
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