Certified Application

CERTIFIED APPLICATION
New Lexington Schools

2549 Panther Drive • New Lexington, Ohio 43764 • (740) 342-4133
Personal Information
Legal Name:*

Legal First NameLegal Last Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email:*
example@example.com
SSN:*
Educator OH/ID:*
Upload Attachments

Cancelof
Phone Number:*
Please enter a valid phone number.
Alt. Phone Number:
Please enter a valid phone number.
Teaching Preference
Elementary (K-5)Middle School (6-8)High School (9-12)Other
EDUCATION

Official/original transcripts will be required at the time of employment to verify placement on salary schedules.
Name of School/College:*
Field of Study:*
GPA:*
Degree/Hours:*
Name of School/College:
Field of Study:
GPA:
Degree/Hours:
Name of School/College:
Field of Study:
GPA:
Degree/Hours:
Name of School/College:
Field of Study:
GPA:
Degree/Hours:
Teaching Experience

(list most recent first)
Name of School District:
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Position Held:
Type of Contract:
Have you ever been discharged or requested to resign from a teaching position?*

YesNo
If yes, explain
List any experiences, skills or qualifications relevant to the position you are applying for. Examples... professional experience, coaching/advising, tutoring, volunteer activities, community activities, etc.
References
Name:*
Relationship: *
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*
Please enter a valid phone number.
Name:*
Relationship: *
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*
Please enter a valid phone number.
Name:*
Relationship: *
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*
Please enter a valid phone number.
Name:*
Relationship: *
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*
Please enter a valid phone number.
PLEASE READ CAREFULLY BEFORE SIGNING
It is understood and agreed that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employer’s service if I have
been employed.

I give the employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations, or organizations for furnishing such information.

If I am employed by the New Lexington Board of Education I agree to abide by the policies, rules, and regulations adopted by the New Lexington Board of Education. I agree that any claim or lawsuit relating to my service with the New Lexington School District must be filed no more than six (6) months after the date of employment action that is subject of the claim or lawsuit. I waive any statute of limitations to the contrary.
Signature*

Clear
Date*

MonthDayYear
Date
Required From All Applicants By Ohio Law

All applicants are subject to a BCI & FBI background check.
This must be completed before working for New Lexington Schools.

An Equal Opportunity Employer
Should be Empty:

New Lexington Schools

Personal Information

Teaching Preference

EDUCATION

Teaching Experience

References

PLEASE READ CAREFULLY BEFORE SIGNING