Central Heights USD

1) Date of Filing

2) Date Available

3) Name

(Last, First, Middle)

4) Current Address

(Street, City, State, Zip Code)

5) Contact Information

(Email & Phone Number)

6) Desired Position(s)

7) Current Position and Employer

8) Current Yearly Salary

9) Do you currently have a valid Kansas Teaching Certificate

Yes

No

10) Please list all Certification Areas, Grade Levels, and Expiration Dates

(EX.. English- 7-12- Expires 01/01/2031)

11) Please provide all of your Professional Experiences below

Years taught, School with Address, and Grade Assignments (2011-2021/ Anderson County HS, Garnett KS/ English I, II, III, IV, College English)

12) Current administrator information

Name, phone number, email

13) Professional Reference Document

Please upload your qualified* reference contact information. *Persons who have knowledge of your classroom work as a teacher or as a student in college are considered qualified references. (i.e. cooperating teacher, college supervisor, principal, department chairman, supervisor, others.)

Max 10 files | 200 MB limit

14) Other than minor traffic offense for speeding parking violations, etc., have you ever been convicted of any criminal offense?

Yes

No

15) If answered yes, please explain (optional)

Conviction of a crime is not an automatic bar to employment. The district will consider the nature of the offense, the date of the offense, and the relationship between the offense and the position for which you are applying.

16) Why do you desire to leave your present position, or why did you leave your last position? (Questions do not apply to those graduating this year.) (optional)

17) Have you ever been involuntarily terminated from employment?

Yes

No

18) If yes, please give then name of the employer, the date and the reason for termination (optional)

19) Are you aware of any reason you would not be able to perform the duties of the position for which you are making an application?

Yes

No

20) If yes, please explain. (optional)

21) What college activities, honors, and awards have you received? (optional)

22) What student activities are you able and willing to sponsor?

Sports, clubs

23) REASON(S) FOR ENTERING THE EDUCATION PROFESSION

On the space provided, in your own words, please type your reason(s) for entering the education profession and what you are looking for in a teaching or administrative position.

24) AGREEMENT

1. I certify that all the information provided by me in this application is true and complete. I understand that any misstatement, falsification, or omission of information is grounds for refusal to hire or, if I am hired and the same is discovered thereafter, termination.

Yes

No

25) Agreement

I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability for any damages that may result from furnishing such information to you. I authorize any background checks by any third party.

Yes

No

26) Agreement

I authorize you to request, receive and verify all information given on this application and I release you from all damages that may result from your doing so.

Yes

No

27) Agreement

I authorize you to conduct a criminal background investigation using any and all methods necessary to successfully complete such investigation and I release you from all liability for any damages that may result from your doing so. I understand that if I am offered provisional employment in the school district that my fingerprints may be taken and a request made for a state and national criminal background check.

Yes

No

28) Agreement

I further understand that if the results of this criminal history check reveal that I have been convicted of any offense or any attempt to commit any offense specified in K.S.A. 1999 Supp. 72-1397 and amendments thereto that my employment may be terminated. I understand that this application and records become the property of the District, which reserves the right to accept or reject it. I further agree to observe all rules, regulations, and policies of the District.

Yes

No

29) Agreement

I have read all of the above agreements and by signing the below, accept these agreements.

Signature

I understand that my typed signature is the legal equivalent of my handwritten signature on this document.

31) Please upload a complete and current Resume.

Max 10 files | 200 MB limit

Central Heights USD

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