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School Union #7 APPLICATION FOR SUBSTITUTE TEACHING_______________________________________________________________________________________ SCHOOL UNION #7 DOES NOT DISCRIMINATE IN THE OPERATION OF ITS EDUCATIONAL AND EMPLOYMENT POLICIES AND WILL HONOR ALL APPROPRIATE LAWS RELATIVE TO DISCRIMINATION. DATE: ______________________ NAME: ___________________________________________ ADDRESS: _________________________________________ ___________________________________________________ PHONE: ________________ EDUCATION: Transcripts, including grades, from all college(s)/university(s) attended 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 ______________________ _______ ________________ ________________ ______________________ _______ ________________ ________________ ______________________ _______ ________________ ________________ ______________________ _______ ________________ ________________ EXPERIENCE: Please list previous teaching/substituting experience. Please attach a copy of your resume. Grade/Subject Position Employer Dates (from/to) ________________ ______________ ____________________ _______________________ ________________ ______________ ____________________ _______________________ ________________ ______________ ____________________ _______________________ ________________ ______________ ____________________ _______________________ AREAS OF INTEREST:
*** Please inform this office at 284-4505 if at any time you become unavailable for substitute work so that we can remove your name from our list.*** REFERENCES: Please provide three references who are not related to you who are familiar with your work as a teacher, substitute or who know of your experience working with youth. Name Address Telephone ________________ _________________________________________ ____________ ________________ _________________________________________ ____________ ________________ _________________________________________ ____________ BACKGROUND: 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 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 Have you ever been charged with or investigated for sexual abuse or harassment of another person? Yes___No___ Have you ever been convicted of a crime (other than a minor traffic offense)? Yes___No___ Have you ever entered a
plea of guilty or “no contest” (nolo contendere) to any crime Have you ever had a
professional license or certificate suspended or revoked in any state, or
Has any court ever
deferred, filed or dismissed proceedings without a finding of guilty and
required If you have answered YES to any of the previous questions, provide full details below including, with respect to court actions, the date, offense in question, and the address of the court involved. Attach additional sheets if necessary. Conviction or other disposition of a crime is not necessarily an automatic bar to employment. _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ WHERE DID YOU LEARN OF THIS POSITION? _____www.ServingSchools.com _____Journal Tribune ____Portland Press Herald ____Friend _____Other, please specify________________________________ SIGNATURE 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 APPLICATION FOR SUBSTITUTE TEACHING 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), If applicable ________ Copy of Resume ________ YES to any of the questions in the Background section explained ________ Application signed ________ I-9 Verification form completed with two forms of identification ________ W-4 Form completed and 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. NOTE: EMPLOYMENT CANNOT BE FINALIZED UNTIL THE APPLICANT HAS COMPLETED REQUIREMENTS FOR COMPLETE BACKGROUND CHECKS AND FINGERPRINTING AS REQUIRED BY MAINE STATE STATUTE.
Interviewed on: _______________________
By Administrator: _____________________
Placed on Substitute List: _______________
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