Substitute Staff Application

Scott County School District 2

Support & Substitute Staff APPLICATION FORM
Full Name (exactly as it appears on Social Security card) *

First Name Middle Name Last Name
Date of Birth *

Month Day Year
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com

Have you ever been employed by Scott County School District 2 as a substitute or permanent employee in the past? *

YES NO

Applying for a PERMANENT or SUBSTITUTE Position? *

Permanent Position Substitute Position BOTH
Permanent (or summer) Position(s) Applied For *
STOP

All applications for positions that are not Substitute Positions should be submitted in the district's employee portal. Use the following link to go to the district webage with that information:

https://www.scsd2.k12.in.us/about_scott_2/employment

Otherwise, if you are applying for a Substitute Position, continue with this application.

	Previous Scott 2 Job Title(s)	Date(s)
Previous Scott 2 Jobs

Select ALL the substitute positions in which you are interested below *

	Select at least one and as many as six substitute positions
1
2
3
4
5
6
7.

In addition to the criminal history checks required for other positions, assignment to a PreK substitute position requires a finger print check which is completed at the Scott County Sheriff's Dept. If you are interested in a PreK substitute position, more details about that process will be provided to you by the Scott 2 business office *

Yes, I understand the additional requirement for the PreK substitute teaching assignment.

Do you have a valid Indiana Substitute permit for this school year? *

Yes No
A valid Indiana Substitute Permit is required for substitute teacher and substitute aide positions. The cost (as of July 2020) is $16.32. A copy of your permit must be on file in the school district central office prior to being assigned a substitute job. Information below is copied from the Indiana Department of Education website.

Substitute Permit Requirements

Individuals applying for Substitute Permits must:
1. Hold a high school diploma or high school equivalency certificate;
2. Be 18 years of age or older; and
3. Meet the requirements set forth in the screening process of the school employer.
Once these requirements are met, applicants should apply via the Indiana Department of Education's Licensing Verification and Information System (LVIS).

Application Process
1. Each school employer will recommend individuals for Substitute Permits through the application process. The superintendent or his/her designee will verify the applicant's employment and application through LVIS . Each application for a Substitute Permit must be submitted and paid through LVIS .
2. The Office of Educator Licensing will issue the Substitute Permit in the applicant's name and the school employer’s name. The applicant may print a copy of the permit by logging into the applicant’s LVIS account.
3. The Substitute Permit is valid only for the requesting school employer unless the school employer has a reciprocity agreement for use of substitute teachers with another school employer.
4. Substitute Permits are valid for three years. The validity period begins on the date the applicant pays for the permit application in LVIS.
5. A Substitute Permit is not renewable. Once it expires, an applicant must apply for a new original Substitute Permit.
6. The fee for a Substitute Permit is $15.00 + $1.32 processing fee.
7. A license or permit that is valid on the first day of school in the school in which the license holder is employed is considered valid for the duration of the school year.
Step-by-Step Instructions: Click Here
School Substitute Teachers and Substitute Aides must attend a face-to-face orientation session annually and prior to being assigned a substitute job. Orientation sessions are scheduled every 30-60 days, depending upon need. Within approximately two weeks of the time this application is submitted, you will be contacted and provided the date and time of the next orientation session. *

Yes, I understand all of the above regarding participation in an orientation session.

List School Preference, If Applicable
ie. Johnson Elem, Lexington Elem, Scottsburg Elem, Vienna-Finley Elem, Middle School, High School

	Permit #	Issue Date:	Expiration Date:
Substitute Permit Information

EDUCATION & SKILLS
Education Completed *
Brief Details
Computer Knowledge/Experience *
Brief Details
Word Processing Knowledge/Experience *
Brief Details
Technical Experience *
Brief Details
What qualifies you for the position? *

PREVIOUS WORK EXPERIENCE & REFERENCES

WORK EXPERIENCE *

	EMPLOYER NAME	JOB/TITLE	START DATE	END DATE
1.
2.
3.
4.
5.

REFERENCES

Provide Complete Information Below for References *

	Reference Name	Reference Address	Phone	Occupation
1
2
3
4

If you wish to attach a resume (optional) use the file upload option below:

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Scott County School District 2, in considering my application for employment, may verify the information set forth on this application and obtain additional background information relating to my background. I authorize all persons, schools, companies, corporations, credit bureaus and law enforcement agencies to supply any information concerning my background.
I have read, I understand, and agree to this statement. Please type INITIALS below: *
TYPED INITIALS
I understand that Scott County School District 2 has a commitment to maintain an alcohol/drug free workplace and that Scott County School District 2, unless prohibited by state law, requires a drug- screening test as a part of its selection, and hiring process. I understand that such drug screening will consist of a urine sample or other medically recognized test designed to detect traceable amounts of a controlled substance in my body. If after a second confirmatory test approved by the Superintendent, and it is determined that my specimen contains a controlled substance or was adulterated or substituted, I will be disqualified from consideration for employment, and any offer of employment will be withdrawn. I further understand and agree that, if I am employed, I may be required to submit to alcohol/drug-testing under certain circumstances during my employment.
I have read, I understand, and agree to this statement. Please type INITIALS below: *
TYPED INITIALS
I certify that the information on this application is correct and I understand that any misrepresentation or omission of any information will result in my disqualification from consideration for employment or, if employed, my dismissal. I understand that this application is not a contract, offer, or promise of employment and that if hired, I will be able to resign at any time for any reason. Likewise, the School Corporation can terminate my employment at any time with or without cause, unless otherwise required by law. I further understand that no one other than the Board of School Trustees or Superintendent of Schools has the authority to enter into an employment contract or agreement with me, and that my at-will employment can be changed only by a written agreement signed by the Superintendent of Scott County School District 2, and approved by a majority of the board of School Trustees.
I have read, I understand, and agree to this statement. Please type INITIALS below: *
TYPED INITIALS

AUTHORIZATION AND RELEASE

PLEASE READ ALL OF THE FOLLOWING CAREFULLY PRIOR TO SIGNING AND SUBMITTING THIS APPLICATION:

The cost of required criminal history/DCS registry checks will be the responsibility of the applicant/employee. As of July 2020, this cost is at least $30 and may be more depending upon any name changes or changes of residence in different counties and/or states. Additional requirements are in place for substitute positions in PreK classrooms (ie. finger print check).

My signature below constitutes authorization to check my employment history in accordance with IC 10-13-3, including without limitation, evaluation, criminal arrest and conviction record checks, reference checks, driving record, child abuse registry, and release of investigator information possessed by any private or public employer or any state, local, or federal agency. I further authorize those persons, agencies, or entities that the Scott County School District 2 Corporation contacts in connection with my employment application to fully provide the Scott County School District 2 Corporation 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 the Scott County School District 2 Corporation, its agents and officials, or against anyone who provides such information.

I understand any false or misleading information on this application shall be fully sufficient grounds to refuse to employ, or after having been employed, shall be immediate cause for dismissal.

I understand that this application is good only for 365 days from today’s date. If I still desire a position with the School Corporation after this application expires, it will be my responsibility to fill out a new application and file it with Scott County School District 2. Otherwise, Scott County School District 2 will not consider me for employment after this application expires.
Signature *

Clear
Today's Date *

Month Day Year
Date
Date of Application:

Month Day Year
Date
Signature 2

Clear
Signature 3

Clear
Should be Empty:

Scott County School District 2

Support & Substitute Staff APPLICATION FORM

STOP

Substitute Permit Requirements

Application Process

EDUCATION & SKILLS

PREVIOUS WORK EXPERIENCE & REFERENCES

REFERENCES

Acknowledgements