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Application for Professional and Classified Positions Below (please copy and paste into your own document)
VICTORY CHARTER SCHOOL Application for Professional Position Personal Information: ________________________________________________ Last Name First Name Middle Name Social Security # ________________________________________________________________________ Street Address City State Zip ________________________________________________________________________ Home Phone 2nd Phone number E-Mail Certification ( Please enclose copy)_____________________________________________________________ Type Level Endorsement Expiration Date Which position are you applying for? ________________________________________________ Experience: List all position held starting with the most recent. Are you presently teaching in another school district? Yes / No Total contract experience: ________________________________ ______________________________________________________ Month / Year Position District & School Employer 1. _____________________________________________________________________ 2. _____________________________________________________________________ 3. _____________________________________________________________________
Education: List all college and university preparation. College and University City / State Dates Type/Date of Degree 1. ___________________________________________________________ 2. ___________________________________________________________ 3. ___________________________________________________________ Legal Information: Have you ever been dismissed from, or resigned from employment as a result of, or arising out of an allegation of sexual misconduct or harassment involving a person under the age of 18 years at the time when the alleged act occurred? Yes / No Have you ever been found guilty, or entered a guilty plea or plea of no contend ere involving a crime? Yes / No (If you answered yes to either of the above questions, please provide complete details, starting date, charge, place and action taken. Attach a separate sheet if necessary) ________________________________________________________________________ ________________________________________________________________________ Do you have any physical, emotional or mental limitation which may affect your ability to perform the position for which you have applied? Yes / No (If yes, what can be done to accommodate your limitations?) ________________________________________________________________________ I CERTIFY THAT THE INFORMATION IN THIS APPLICATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT AN OMISSION OR FALSIFICATION OF ANY INFORMATION IN THIS APPLICATION WILL RESULT IN REFUSAL OF, OR IMMEDIATE DISCHARGE FROM EMPLOYMENT. I UNDERSTAND THAT EMPLOYMENT IS CONTINGENT UPON INBESTIGATION OF ANY OR ALL STATEMENTS CONTAINED IN THIS APPLICATION AND AUTHORIZE THE RELEASE OF ANY INFORMATION FROM PERSONS NAMED IN THIS APPLICATION. IN THE EVENT I AM EMPLOYED BY VICTORY CHARTER SCHOOL, I AGREE TO ABIDE BY ALL ITS APPLICABLE POLICIES, PROCEDURES, RULES AND REGULATION. __________________________________________________________________ Date Signature
(Complete the following in your own handwriting and limit your response to the space given.) Date: _____________________ Name: ____________________ Position desired: ______________ How would you access and impact the climate of your work setting (classroom and school)?
What percent of your day do you see yourself involved in direct instruction?
The students are rewarded for hard work, kindness, etc…. What is the teacher’s role?
Victory Charter School Nampa, Idaho CLASSIFIED AN EQUAL OPPORTUNITY EMPLOYER Date of Application: _______________ Social Security # ______________ First Name: ______________ M.I.: _____ Last Name: _______________ Street Address: ______________________ City: _____________________ State: ________ Zip Code: __________ Home Phone #: ______________ Business Phone #: ________________ Other Name(s) under which recommendation may be listed: _______________________ With whom (name and daytime phone #) could a message be left?___________________ Title of position applying for (please be specific): _______________________________ Please consider me for : ______ Full time position only _______Part Time Position Only Probable availability date: ___________________ Have you ever been convicted, been given a suspended sentence, been given a withheld judgment, or pleaded no contest in regard to felony? _________ If yes, please explain:
Training: Name and Location Did you graduate? Degree/Date Given High School: ______________________________________________________________ College: __________________________________________________________________ Other: ___________________________________________________________________ List all computer software you can successfully operate: ___________________________ _________________________________________________________________________ References: List three (3) references capable of assessing your ability to perform the duties of the position for which you are applying: Name Address Telephone Number 1._____________________________________________________________________________ 2. _____________________________________________________________________________ 3. _____________________________________________________________________________ Work Experience: List most recent first. Employer/Firm ________________________Address: ___________________ Phone # ____________ Position title: _____________________________ Starting Date: ____________________________ Leaving Date: ____________________ Reason for leaving: _________________________________________________________ Supervisor’s Name: ___________________________ May we call this employer? _____________ Employer/Firm ________________________Address: ___________________ Phone # ____________ Position title: _____________________________ Starting Date: ____________________________ Leaving Date: ____________________ Reason for leaving: _________________________________________________________ Supervisor’s Name: ___________________________ May we call this employer? _____________ Employer/Firm ________________________Address: ___________________ Phone # ____________ Position title: _____________________________ Starting Date: ____________________________ Leaving Date: ____________________ Reason for leaving: _________________________________________________________ Supervisor’s Name: ___________________________ May we call this employer? _____________ By filling in my name below, I HEREBY CERTIFY that all information furnished on this application is true and correct.
Name/Signature: ______________________ Victory Charter School is an equal opportunity employer/educator. Applications from all qualified individuals are considered.
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Victory Charter School | 1081 Lewis Lane | Nampa, ID 83686 | Office: 208.442.9400 | Fax: 208.442.9401 © 2006 Victory Charter School |
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