Teacher-Application
Today's Date
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Month
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Day
Year
Date
Full Name
First Name
Last Name
Date of Birth
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Month
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Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Other Phone Number
Please enter a valid phone number.
Email
example@example.com
Emergency Contact
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Teaching areas and age levels with which you feel most competent.
Physical/Earth Science
Chemistry
Biology
Space Science
Physics
Environmental Science
Visual Art
Photography
Music
Dance/Movement
Theatre
Digital Art
Sculpture
Clay
PK (ages 4-5)
K-2nd (ages 5-8)
3rd-5th (ages 8-11)
6th-12th (ages 11-18)
Adults (ages 18+)
Other
Notes (optional):
Days and hours (Mon. – Sat.) or Tuesday and/or Thursday evenings when you will be available for possible teaching assignments.
Reference (not a relative)
First Name
Last Name
Places and Dates of your past experience with above activities: education, employment, personal experience, etc. Attach an updated resume if it covers the requested information. Please note any virtual teaching experience as well. You may provide links to any videos you have to showcase your teaching.
Reference Address
Reference Phone
Please enter a valid phone number.
Signature: Icertify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, or educational history and other related matters as may be necessary for an employment decision. I hereby release employers, schools or persons from all liability in responding to inquiries in connection with my application. In the event I am employed, I understand that false or misleading information given in my application or interviews may result in discharge.
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Date
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Month
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Day
Year
Date
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