Reagan County ISD Employment Application

An Equal Opportunity Employer*
CONTACT INFORMATION
Last Name* First Name* Middle Initial*
Date*

MonthDayYear
Social Security #*
Driver's License #*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other Address where you may be reached
Other name that may appear on records
Used for Certification, reference, and criminal history record checks
POSITION DATA
List the position(s) for which you are applying*
Type of Employment
Date you can begin work*

MonthDayYear
Date
Have you been employed by Reagan County ISD in the past?*
If you answered yes, provide dates of employment
SPECIAL SKILLS
List specific skills, software proficiency, and any machines or equipment you can operate. Include number of years of experience.
WORK EXPERIENCE

Please provide a complete list of all positions you have held in the past 10 years. List the most recent years first.

Employment History*

Rows	Employer Name & Location	Position Held	Dates Employed	Supervisors Name	Reason for Leaving
1
2
3
4

Attach additional sheets if necessary (bus driver applicants, see addendum). Attach resume if available.

Cancelof

Please list references the district can contact regarding your work history.*

Rows	Full name of Reference	School District/Firm name	Mailing Address	Position/Title	Phone Number
1
2
3
4

Educational Training
List the highest level of education attained:*
Licenses and Certificates granted:

Education *

Rows	Name & Location of Schools Attended	Course of study & Major/Minor	Diploma, Degree, Certificate, or License Granted	Year Graduated (College Only)
1
2
3
4

GENERAL INFORMATION
Do you have a relative who serves on the Board of Education or is an employee of Reagan County ISD?*
If yes, please provide the relative's name and relationship:
Have you ever been convicted of, pled guilty or no contest (nolo contendre) to, or received probation, suspension, or deferred adjudication for a felony or any offense involving moral turpitude (including, but not limited to, theft, rape, murder, swindling, and indecency with a minor)?*
If yes, please state where, when and the nature of the offense
(A felony conviction is not an automatic bar to employment. The district will consider the nature, date, and relationshipbetween the offense and the position for which you are applying.)
VERIFICATION
I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing the same to you. I understand that the district is required by Texas Education Code to review criminal history of applicants.
Signature*

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Date*

MonthDayYear
Date
This application becomes the property of the district. The district reserves the right to accept or reject it. This application shall be considered active forblanks months. If you have not received a response during this time period, you may reapply or reactivate your application.
*Applicants for all positions are considered without regard to race, color, sex (including
pregnancy), national origin, religion, age, disability, genetic information, veteran or military
status, or any other legally protected status
Should be Empty:

CONTACT INFORMATION

POSITION DATA

SPECIAL SKILLS

WORK EXPERIENCE

Educational Training

GENERAL INFORMATION

VERIFICATION