Application for Teaching Position

Application for Teaching Position

Updated March 2021
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Home Phone *
Please enter a valid phone number.
Cell Phone *
Please enter a valid phone number.
Email *
example@example.com
Website
PREFERRED AGES TO TEACH

Please rank according to preference and add any additional information as desired.
Preschool *
Youth K - 5 *
Middle School *
High School *
Adult 18+ *
Addition Details / Description About Ages
PREFERRED MEDIA

Please rank according to preference and add any additional information as desired.
Painting *
Drawing *
Photography *
Printmaking *
Mixed Media *
Performing Arts / Dance *
Other
If Other, please describe:
Addition Details / Description About Media
TEACHER CHECKLIST (please check all that apply) *
EDUCATION BACKGROUND

Please submit additional education if necessary.
EDUCATION 1 *

High School

Address

Address (City, State/Province) Year Graduated

Degree / Certificate
EDUCATION 2

College / Institution

Address

Address (City, State/Province) Year Graduated

Degree / Certificate
EDUCATION 3

College / Institution

Address

Address (City, State/Province) Year Graduated

Degree / Certificate
Additional Education Information or Documents

Cancel of
EMPLOYMENT HISTORY

Please submit additional employment if necessary.
Employer 1

Employer

Address (City, State/Province)

Supervisor Phone Number

Position
Employer 2

Employer

Address (City, State/Province)

Supervisor Phone Number

Position
Employer 3

Employer

Address (City, State/Province)

Supervisor Phone Number

Position
Additional Employment Information, Resume/CV and or Documents

Cancel of
REFERENCES

Please include at least one personal and one employer or teaching art postion reference.
Reference 1 *

First Name Last Name
Phone *
Please enter a valid phone number.
Email
example@example.com
Relationship to Applicant *
Reference 2 *

First Name Last Name
Phone *
Please enter a valid phone number.
Email
example@example.com
Relationship to Applicant *
Reference 3 *

First Name Last Name
Phone *
Please enter a valid phone number.
Email
example@example.com
Relationship to Applicant *
CRIMINAL HISTORY

Please note that a “Yes” answer to either of the following questions will not necessarily disqualify you from employment. Factors such as the age and time of the offense, seriousness and nature of the violation, and rehabilitation will be considered when making any employment decisions.
Have you ever been convicted of, or pleaded guilty, or “no contest” to any misdemeanor or felony? (Do not include convictions that were sealed or expunged pursuant to a court order.) *

Yes No
Are you currently awaiting trial for any criminal offense? *

No Yes
Please explain any "Yes" answer.
Submit any additional information if necessary.
Additional Criminal History Information or Documents

Cancel of
CERTIFICATION AND RELEASE

Please read carefully and sign below:

I authorize the Northville Art House, Inc. (NAH) to check my statements, references, and those former employers I have indicated. I certify all the information in this application to be true and agree that any misrepresentation or concealment of a material fact will be sufficient cause for termination of teaching contract(s). I understand that nothing contained in this application or in the granting of an interview is intended as a teacher’s contract between NAH and me. No promises regarding teaching classes have been made to me and I understand that any such promise or guarantee would not be binding upon NAH. If a Teacher’s Contract is approved by the NAH's Education Director, I understand and agree that my contract can be terminated any time at the option of either NAH or me. I have read the current Safety and Security Policy and the Teacher Guidelines and understand that upon signing a contract and being granted approval by the NAH Education Director, I will be retained to perform specific services as an independent contractor.

I further acknowledge that the Northville Art House, Inc., and its officers, members, employees, and agents accept no responsibility or liability whatsoever for any injury, loss or damage to the teacher's person, equipment or art work.
Signature of Applicant *

Clear
Date *

Month Day Year
Date
------------------- OFFICIAL USE ONLY --------------------
Signature of NAH Education Director

Clear
Date Application Reviewed

Month Day Year
Date
Should be Empty: