Application for Employment

Application for Employment
Name*

First NameMiddle NameLast Name
Position applying for*
Date of Availability*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code

General Information
YesNo
YesNo
YesNo
If yes, what language?
YesNo
If yes, what District?

Educational Information
Name of High School*
City, State*
College/University/Trade School, City/State
Degree/Major/Type of Course
Number of Years Completed
Credits Earned
College/University/Trade School, City/State
Degree/Major/Type of Course
Number of Years Completed
Credits Earned
College/University/Trade School, City/State
Degree/Major/Type of Course
Number of Years Completed
Credits Earned

Employment History/Experience

Please list your present and former employment with the most recent employer first. Include any military experience. Please also attach a current resume.
Employer Name, City/State*
Job Title*
Dates Employed*
Employer Name, City/State
Job Title
Dates Employed
Employer Name, City/State
Job Title
Dates Employed
Employer Name, City/State
Job Title
Dates Employed

References

Please list references (no relatives) - at least three. List people who are able to answer questions concerning your qualifications and work skills. Past or present supervisors are preferred.
Name/Relationship
Occupation
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name/Relationship
Occupation
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name/Relationship
Occupation
Phone Number
Please enter a valid phone number.
Email
example@example.com

Veterans Preference
To receive preference as a veteran you must have served on active duty in the Armed Forces of the United States (US): 1) For more than 90 consecutive days beginning on or before January 31, 1955; or 2) For more than 178 consecutive days; or 3) For 178 days or less and has a disability rating from the US Department of Veteran’s Affairs; or 4) For at least one day in a combat zone; or 5) Received a combat or campaign ribbon or an expeditionary medal for service in the Armed Forces. To qualify under 1-5 above you must have been discharged or released under honorable conditions; or 6) Is receiving a non-service connected pension from the US Department of Veteran’s Affairs To receive preference, you must attach verification of eligibly: a copy of your DD214/DD215 form; or a letter from the US Department of Veteran’s Affairs indicating you receive a non-service connected pension to your application.

To receive preference as a disabled veteran you must be: 1) A person whose discharge or release from active duty was for a disability incurred or aggravated in the line of duty; or 2) Entitled to disability compensation under laws administered by the US Department of Veterans Affairs, or 3) Awarded the Purple Heart for wounds received in combat. To receive preference as a disabled veteran you must attach verification of eligibility: a copy of your DD214/DD215 form; and a copy of your veterans' disability preference letter from the Department of Veterans' Affairs (unless included on DD).

Veteran’s and Disabled Veteran’s preference points are not added when a Veteran or Disabled Veteran fails to meet the minimum or the special qualifications for a position.

For additional information on Veterans' Preference eligibility, including definition of the terms "veteran" and "disabled veteran," contact the Oregon Department of Veterans' Affairs at 1-800-692-9666.
Fingerprint Based Criminal History Verification
In accordance with OAR 581-021-0500 and Board policy, any person hired by a school district or charter school is subject to fingerprint-based criminal history verification. All offers of employment are contingent upon the results of the criminal history verification.
Authorization to Obtain and Release Information
I authorize the charter school to check my references, to obtain information from my prior employers and educational institutions, and to take other actions to investigate any information provided in my employment application, and to obtain information relevant to evaluating my qualifications and fitness for a position.

I authorize my listed references, current, and past employers and educational institutions, and anyone else who has information about my work history, education, qualifications, or fitness to provide such information to the charter school for which I have completed an employment application. I release the school district and all persons providing this information to the charter school, from any liability whatsoever for obtaining and providing that information, regardless of the results. Please indicate you have read and agree to these terms by signing and dating below.

I understand that any omissions on this application may prevent my application from being evaluated. I authorize the charter school to obtain information about my criminal records. I authorize all governmental agencies to provide information about my criminal records to the charter school. I verify that all information on this employment application is true and complete. I understand that any misrepresentation, falsification, or omission on this application or on other documents submitted to the charter school will be sufficient cause for this application not to be considered by the charter school or for discharge if I have been employed.
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Please Attach to Application:

Cover Letter
Resume
Three letters of recommendation (Certified Positions)
Copy of your current Oregon Teaching License (Certified Positions)
Teaching Philosophy (Certified Positions)
Transcripts (Certified Positions)

Crater Lake Academy IS AN EQUAL OPPORTUNITY EMPLOYER AND EDUCATIONAL PROVIDER
In accordance with Federal and State legislation, including Title IX, title VIII, ORS 659.150, CLA does not discriminate on the basis of race, sex, religion, age, national origin, disability or marital status in employment or educational programs.
Should be Empty:

Application for Employment

Personal History

General Information

Educational Information

Employment History/Experience

References

Veterans Preference

Fingerprint Based Criminal History Verification

Authorization to Obtain and Release Information