Orleans Community Schools
Certified Personnel Application
Civil Rights Nondiscrimination Statement
Orleans Community Schools is committed to equal opportunity. It is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, handicapping conditions, or national origin, including limited English proficiency, in any employment opportunity.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Social Security Number
Date Available For Assignment
-
Month
-
Day
Year
Date
List in Order of Preference Grades/Subjects you Wish to Teach
List Experience With Children
Check Each Area You Feel Confident in Directing
Drama
Speech
Music Groups
Intramurals
Publications
Other
List Departmental Clubs You Would be Willing to Lead
List Sports You Would be Willing to Lead
High School Attended, City and State, Dates Attended
College or University and Dates Attended
Student Teaching - Grade Taught, School, and Supervising Teacher
List Teaching Experience, Beginning With Most Recent Assignment
References: List at Least Three (3) Persons, Their Position, and Contact Information
Teaching License Area(s), License Number, and Expiration Date
Teacher's Retirement Fund Number
Has your teaching contract ever failed to be renewed:
Yes
No
If so when, and what was the reason?
Have you ever been convicted of a felony?
Yes
No
If yes, explain
Give a brief statement of your philosophy of education and any other information you may desire.
Signature
Submit
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