Classified Application

Classified Position Application

(Substitute, custodian, library, aide, administrative assistant, etc)

Crowley County School District Re-1-J
Ordway, CO 81063
Phone (719) 267-3117
Fax (719) 267-3130

If you need help to fill out the application form or during any phase of the application, interview, or employment process, please notify the district office and every reasonable effort will be made to accommodate your needs in a timely manner.
Position Applying for*
INSTRUCTIONS: Complete (please type or print) all sections accurately.
Name (Last, First, Middle - Former/Maiden*
Mailing Address*
City, State, Zip*
Email*
example@example.com
Phone Numbers: Home*
Cell Phone
Please enter a valid phone number.
Current job/employment*
Current Salary
If offered, date available to begin employment*

MonthDayYear
Date
List any special skills or training that you have relating to the certified position for which you
Have you ever worked for this school district in the past?*

YesNo
If Yes: What Position
Date

MonthDayYear
Date
Reason for leaving

Background

Each of the following questions must be answered with a "Yes" or "No." If any answer is "Yes," please attach an explanation, include final disposition of investigation. (Note: A "Yes" answer will not necessarily bar you from employment. Each situation will be judged with respect to time, circumstances, and seriousness
Have you ever resigned or been discharged from any position including the armed forces, while under suspicion of having engaged in criminal, immoral, unprofessional conduct, or are you under investigation for such a charge?*
Have you been convicted of a felony or misdemeanor. Including pleading nolo contender, or are you under investigation for any such offense, other than a minor traffic offense? Please note: Driving While Intoxicated (DWI), Driving Under the Influence (DUI), and similar charges are NOT considered minor traffic offenses.*
Have you ever received an unsatisfactory performance evaluation?*
Have you ever received probation or deferred judgment?*
Have you ever served time in prison?*
Have you ever been convicted, resigned, discharged from any position in which the subject of the investigation involved criminal, immoral, or unprofessional conduct with/involving children in which you were in a position of trust?*
I am aware that if offered a position, a background check will be made on behalf of the school district.*

Education: Proof of education level may be required prior to employment

	School Name, City & State	Number of years completed	Diploma, Certificates, etc
High School/GED
College
Other
Other

Prior Employment: Complete full information on last four employers. Start with most recent employer.

	From-To Month/Year	Employer's Name & Mailing Address	Supervisor's Name & Phone Number	Position & Duties	Reason for Leaving
Employer #1
Employer #2
Employer #3
Employer #4

References: Give the names of three persons who have supervised you or who know about your work experiences and are not related to you.

	Name	Mailing address	Position	Phone Number (with area code)	Work
Ref #1
Ref #2
Ref #3

Have you been given a job description or had the essential requirements of the job explained to you?*

YesNo
Do you understand these requirements?*

YesNo
Can you perform the essential requirements of this job with or without reasonable accomodation?*

YesNo
I am aware that it is my responsibility to have a teacher's certificate from the Colorado Department of Education to become a highly qualified teacher. It is the responsibility of the applicant to have all records, transcripts, license and other documentation completed to complete the hiring process, if offered a contract>

YesNo
AGREEMENT

I hereby certify that all statements made on this application are true, accurate, and complete. Any misrepresentations or willful omissions of facts shall be sufficient cause for the disqualification of the application or termination from employment. I hereby authorize the district or its agents to conduct work history and personal reference checks to verify statements on this application form and other materials provided as part of my application for this position. Further, I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages or salary, be terminated at any time without previous notice.
Signature

Clear
Date

MonthDayYear
Date
Please upload resumes, certifications and any other necessary documents here.

Cancelof
Crowley County RE 1-J School District does not discriminate on the basis of race, color, national origin, sex, or disability in its programs or activities. The following Person has been designated to handle inquiries regarding the nondiscrimination policies and grievance procedures:

Superintendent of Schools - Juan Ramirez
1001 Main Street
Ordway, CO 81063
(719)267-3117
Juan.Ramirez@cck12.net
Should be Empty:

Classified Position Application

Background

AGREEMENT