Instructor Application

1
Full Name* This field is required.
First Name
Middle Name
Last Name
2
Are you legally authorized to work in the United States?* This field is required.
YESNO
3
Current Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Email Address* This field is required.
example@example.com
5
Phone Number* This field is required.
6
Social Security Number* This field is required.
7
MSU ID Number
8
Do you have any relatives on the MSU Board of Regents?* This field is required.
YESNO
9
Are you currently employed by Morehead State University?* This field is required.
YESNO
10
Are you exempt or non-exempt
Exempt (salary)
Non-exempt (hourly)
11
Are you part-time temporary or full-time?
Part-time
Full-time
12
What department do you work in and in what capacity/title (i.e. graduate assistant at the Space Science Center).
13
Are you retired from KTRS?* This field is required.
YESNO
14
If so, was it from a public school system?
YESNO
15
Are you retired from KERS* This field is required.
YESNO
16
How did you hear about this position?* This field is required.
17
Have you ever plead guilty to, or been convicted by a judge or jury, of a felony, or do you have any pending felony charges? * This field is required.You must report any felony, even if probation, parole, Alford Plea or pretrial diversion occurred. If you answered ―yes‖ to the above question, please provide the details of each conviction or pending felony conviction below, including DATE (month/year), LOCATION (city, county, state), and NATURE of ALL felony convictions or pending felony convictions. Failure to list ALL felony convictions or pending felony convictions may be considered a falsification of this application and result in: the withdrawal of an offer of employment, restriction on applying for any other positions at the University, and/or termination from current employment with Morehead State University. It is not acceptable to substitute ―will discuss in interview‖ for this information. Although traffic violations and misdemeanors do not have to be listed, please be advised that should you be guilty of these types of offenses and if they are job-related, this may result in the withdrawal of an offer of employment, restriction on applying for any other positions at the University, and/or termination from current employment with Morehead State University.
YESNO
18
If you answered yes to the previous question please list: Nature of Offense(s):A conviction record will not necessarily be a bar to employment. This information will be used only for job- related purposes and only to the extent permitted by applicable law. For this type of employment, Kentucky state law requires a state and national criminal history background check as a condition of employment. Therefore, your signature on the Disclosure and Consent Concerning Consumer and Investigative Consumer Reports, which is part of this application, is required.
19
As of June 1, will you have completed at least a Bachelors degree?* This field is required.A Bachelors degree is required for this position. Please consider applying for one of our other summer positions if you do not meet this requirement.
Yes
No
20
Please upload your resume* This field is required.
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Select files to upload
Max. file size: 10.6MB
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21
Are your references listed on your resume?* This field is required.
YESNO
22
Reference 1
Name
Email
Relationship
Phone
23
Reference 2
Name
Email
Relationship
Phone
24
Reference 3
Name
Email
Relationship
Phone
25
Are you interested in teaching morning CORE classes (English, math, or science)?
Yes
No, just ELECTIVE classes
26
Are you interested in teaching English/Language Arts?
YESNO
27
Sample English class activitiesPlease provide a brief description of activities/curriculum for your English classes.
Huge
Large
Normal
Small
Ok
Ok
28
Are you interested in teaching Math?
YESNO
29
In what areas do you feel comfortable teaching?Check all that apply
Pre-algebra
Algebra
College Algebra
Statistics
Geometry
Trigonometry
Pre-Calculus
Calculus
Other
30
Which area is your top choice?
31
Sample math class activitiesPlease provide a brief description of activities/curriculum for your math classes.
Huge
Large
Normal
Small
Ok
Ok
32
Are you interested in teaching science?
YESNO
33
In what areas do you feel comfortable teaching?
Earth Science
Space Science
Biology/Life Science
Chemistry
Anatomy
Physics
Other
34
Which area is your top choice?
35
Sample science class activitiesPlease provide a brief description of activities/curriculum for your science classes.
Huge
Large
Normal
Small
Ok
Ok
36
Are you interested in teaching afternoon ELECTIVE classes?
YESNO
37
Please upload your elective course descriptions and sample activities.You must submit at least 3 electives for consideration as that is a full course load.
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Select files to upload
Max. file size: 10.6MB
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38
If you have not been employed as an Upward Bound instructor before, please upload an unofficial copy of your transcript. You will still need to mail an OFFICIAL copy to human resources if you are selected for employment.
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Select files to upload
Max. file size: 10.6MB
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39
If the opportunity arrises, would you be interested in working the Research Nights during the summer? Dates: June 10th, 17th, 24th and July 1st from 6pm-9:30pm.This is a project based activity that takes place thought the whole summer. It does not have to be only science! Any project that is based in research is welcome. *This does not mean that you are guaranteed to work Research Night if you choose yes.
YESNO
40
Signature* This field is required.I certify that all information in this application is true and I further understand that any false statement and/or omission in this application will be sufficient grounds for rejection of the application or termination of employment without notice. I understand that completion of an application does not guarantee an interview or employment. References obtained are done so in confidence and I understand that my rights to view any reference material are waived. I also understand that prior to employment, I must provide information related to my identity and employability. Failure to provide appropriate documentation for verification of employment eligibility may result in immediate termination of employment and/or offer of employment. I also understand that a background check is part of the requirements for employment, and I must submit to a background search and that any offer of employment is conditional upon the results of that background search. If i did not upload my transcripts and I attended Morehead State University, I agree to allow them to obtain my transcripts from the Office of the Registrar at Morehead State University.
Clear
41
Date* This field is required.
Date
Year
Month
Day
42
I am aware that I must submit the MSU Part-time application to the Upward Bound office (not Human Resources) in order for my application to be complete.* This field is required.You will be redirected to the jobs website to complete this part of the application process
YESNO
Should be Empty: