SES Certified Employment Application

SES Certified Employment Application
Name *

First Name Middle Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Emergency Contact *

Name Phone Number
Do you a hold or are you eligible to obtain a valid Indiana teacher's license? (If yes, submit a copy of your license with this application *
Position applying for *
Location *
Select "Any" if you are submitting a general application
Education History

List school name, date of graduation, diploma type, beginning with high school.
Employment History

List employer name, dates of work, and position type beginning with most recent.
Employer # 1 *
Employer # 2 *
Employer # 3 *
Employment # 1 *
Employment # 2 *
Employment # 3 *
Employment # 4
References

List at least three references. Name, Relationship, Phone Number
References
Memberships, Affiliations, Community Activities

List Organizations and how you participate in those organizations
What special qualifications do you feel you have for this position? *
Describe the ideal classroom environment. *
Describe the role technology plays in education. *
Share any other details that you believe set you apart as a candidate for this position.
Current Resume *

Browse Files

Cancel of
Letter of Interest *

Browse Files

Cancel of
Teaching License

Browse Files

Cancel of
Request for Background Information
Employment with Shelby Eastern Schools involves contact with our student population. We ask that you complete the questions below to help us evaluate your suitability to work with these students. All applicants for employment are exptected to provide us with this information; you are not being singled out for closer inspection. This request is part of the application itself and any misrepresentation or omission of fact may be grounds for disqualification from further consideration or for terminiation from employment reglards of when the misrepresentation or omission is discovered. "The convication of a crime, an arrest for a crime, any information obtained through the release of investigatory record, or any affirmative answer provided by you on this form, shall not be an automatic bar to employment. The school corporation will consider the nature of any conviction or alleged conduct underlying the arrest, investigatory record, or affirmative response, the date of the alleged conduct in question, your intervening conduct and the relationship between the conviction or alleged conduct underlying the arrest, investigatory record, or affirmative response and the position for which you are applying."

1. If you are now working, is your conduct as an employee or the quality of your work the focus of any investigation by your current employer?
Question # 1 *
If Yes, explain your circumstances in the box following number 4.
2. Have you ever resigned from a job after being disciplined by your employer or after being offered the opportunity to resign rather than be terminated?
Question # 2 *
If Yes, explain your circumstances in the box following number 4.
3. Have you ever been investigated for, charged with or plead guilty or "no contest" to any crime involving the sexual abuse of any person or indecency with a minor?
Question # 3 *
If Yes, explain your circumstances in the box following number 4.
4. Have you ever been charged with a crime, other than a minor traffic offense, where the court has deferred further proceedings without entering a finding of guilt and placed you on probation or in a public service or education program?
Question # 4 *
If Yes, explain your circumstances in the box below.
Explain the circumstances of any "Yes" answers in this box.
I authorize Shelby Eastern Schools to check my employment history, including without limitation, references checks, and to seek the release of investigatory information, including a "limited criminal history", possessed by any private or public employer or any local, state or federal agency. I authorize these private or public employees or local, state or federal agencies to provide the corporation any information they may release concerning the matters described herin, and I will cooperate to the extent necessary to obtain the release of information.

I expressly waive in connection with any request for, or the providing of such information, any claims or causes of action, including without limitation, defamation, infliction of emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against Shelby Eastern Schools, its officials, employees, trustees or agents, or against any provider of such information.

I have read this authorization and release of all claims, and I expressly agree to the terms set out herin.
Signature
Should be Empty:

SES Certified Employment Application

Education History

Employment History

References

Memberships, Affiliations, Community Activities

Request for Background Information