RCSD - Classified Application Rev 3.2022

  • ROSSVILLE CONSOLIDATED SCHOOL DISTRICT

    1 ROBERT EGLY DRIVE, P.O. BOX 11 ROSSVILLE, INDIANA 46065-0011

  • CLASSIFIED APPLICATION FORM

  • BACKGROUND INFORMATION

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • EDUCATION AND CERTIFICATIONS

  • High School:

  • College(s):

  • SCHOOL BUS DRIVER APPLICANTS ONLY

  • Expiration Date
     / /
  • Do You Possess a Yellow Card from the Indiana State School Bus Committee

  • EXPERIENCE

  • REFERENCES

  • Please list the names of three (3) persons who know your professional background and qualification.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • ACTIVITIES

    List any activities, organizations, athletics, etc. that you have participated in while in college or high school.

  • PERSONAL DATA

    Please Check the Appropriate Box and Respond Accordingly
  • Are you presently being investigated or under a procedure to consider you discharge for misconduct by your present employer?*
  • Have you ever been reprimanded, disciplined, discharged, or asked to resign from a prior position?*
  • Have you ever resigned from a prior position without being asked, but under circumstances involving your employer’s investigation of sexual conduct with another person, mishandling of funds, or criminal conduct?*
  • Have you ever been charged with or investigated for physical sexual abuse of another person?*
  • Have you ever been charged with, pleaded guilty or “no contest” to, or been convicted of, any crime involving sexual abuse of any person or any other crime of moral turpitude?*
  • Have you ever been convicted of a misdemeanor and/or felony or ever entered a plea of guilty or a plea of “no contest”, or has any court ever deferred further proceedings without entering a finding of guilty or placed you on probation for a crime?*

  • If you answered yes to any of the questions, please explain below. Please include the date of the incident, charge, the offense in question, the court action taken, if any, and the address of any court involved. Conviction of a crime is not an automatic bar to employment. Rossville Consolidated School District will consider the nature of the offense, the date of the offense, and the relationship between the offense and the position for which you are applying.

  • AUTHORIZATION AND RELEASE

  • I authorize the Rossville Consolidated School District to check my employment history, including without limitation, reference checks, and to seek the release of investigatory information, including criminal history, possessed by any private or public employer or any local, state, or federal agency. I authorize these private or public employers, or local, state, or federal agencies to provide the Rossville Consolidated School District any information they may release concerning the matter described herein, and I will cooperate to the extent necessary to obtain the release of this information.

    I expressly waive in connection with any request for, or provision of such information, any claims or causes of action, including without limitation, defamation, infliction of emotional distress, invasion of privacy, or interference with contractual relation that I might otherwise have against the Rossville Consolidated School District, its officials, employees, trustees, or agents, or against any individual, corporate, and/or agency provider of such information. I have read this authorization and release of all claims, and I expressly agree to the terms set out herein.

  • Date
     / /

  • Rossville Consolidated School District does not discriminate on the basis of race, color, religion, sex, national origin, age, or handicapping condition, including limited English proficiency, in its educational programs or employment policies as required by state and federal laws.

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