Aquilla ISD APPLICATION FOR PROFESSIONAL PERSONNEL

APPLICATION FOR PROFESSIONAL PERSONNEL

An Equal Opportunity Employer
Email2
example@example.com
Email3
example@example.com
Email4
example@example.com

School Name
Date of application

DayMonthYear
Date
School Name
Name

First NameMiddle NameLast Name
Mailing address

Street Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Home Phone/Primary Phone
Please enter a valid phone number.Format: (000) 000-0000.
Cell phone
Please enter a valid phone number.Format: (000) 000-0000.
Other phone
Please enter a valid phone number.Format: (000) 000-0000.
Other name that may appear on records
(Used for certification, reference, and criminal history record checks)

List the position(s) for which you are applying
(Used for certification, reference, and criminal history record checks)
Credentials included with application:
Please Upload

Cancelof
Please Upload

Cancelof
Date you can begin work

MonthDayYear
Date
Have you been employed by {schoolName} the district in the past?
Provide date of employment

MonthDayYear
Date

Education/Training

Rows	Name and location of schools attended	Course of study and major/minor	Diploma, degree, certificate, or license granted	Year graduated (College only)
1
2
3
4

Certificates or Licenses Currently Held:

Other
Describe Valid Other State
Expiration date

MonthDayYear
Date
Category/Level(s) of Certification (1) if applicable
Category/Level(s) of Certification (2) if applicable

Areas of Specialization/Supplemental Certificates/Endorsements (as listed on certification):

Rows	Describe
1
2
3
4
5
6

List teaching experience beginning with most recent years.

Name of School
Location of School
Type of assignment
Taught Start Date

DayMonthYear
Date
Taught End Date

DayMonthYear
Date
Principal’s name
Principal’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for leaving
Do you have additional teaching experience to add?
Name of School
Location of School
Type of assignment
Taught Start Date

DayMonthYear
Date
Taught End Date

DayMonthYear
Date
Principal’s name
Principal’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for leaving
Do you have additional teaching experience to add?
Name of School
Location of School
Type of assignment
Taught Start Date

DayMonthYear
Date
Taught End Date

DayMonthYear
Date
Principal’s name
Principal’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for leaving
Do you have additional teaching experience to add?
Name of School
Location of School
Type of assignment
Taught Start Date

DayMonthYear
Date
Taught End Date

DayMonthYear
Date
Principal’s name
Principal’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for leaving
Do you have additional teaching experience to add?
Upload all additional work experience

Cancelof

Please provide a list of all other jobs or administrative positions you have held in the past.
Employer name
Location
Position/title held
Employment Start Date

DayMonthYear
Date
Employment End Date

DayMonthYear
Date
Supervisor’s name
Supervisor’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for leaving
Do you want to add another work experience?
Employer name
Location
Position/title held
Employment Start Date

DayMonthYear
Date
Employment End Date

DayMonthYear
Date
Supervisor’s name
Supervisor’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for leaving
Do you want to add another work experience?
Employer name
Location
Position/title held
Employment Start Date

DayMonthYear
Date
Employment End Date

DayMonthYear
Date
Supervisor’s name
Supervisor’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for leaving
Do you want to add another work experience?
Employer name
Location
Position/title held
Employment Start Date

DayMonthYear
Date
Employment End Date

DayMonthYear
Date
Supervisor’s name
Supervisor’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for leaving

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

Rows	Full name of reference	School district/ firm name	Mailing address	Position/title	Area code/ phone number
1
2
3
4

Do you have a relative who serves on the Board of Education or is an employee of {schoolName}?
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)?
Please state where, when, and the nature of the offense

Verification
Signature
Date

DayMonthYear
Date

This application becomes the property of the district. The district reserves the right to accept or reject it.

*Applicants for all positions are considered without regard to race, color, sex (including pregnancy, sexual orientation or gender identity), national origin, religion, age, disability, genetic information, veteran or military status, or any other legally protected status. Additionally, the district does not discriminate against an applicant who acts to oppose such discrimination or participates in the investigation of a complaint related to a discriminating employment practice.

In accordance with Title IX, the district does not discriminate on the basis of sex and is required not to discriminate on the basis of sex in its educational programs or activities. The requirement not to discriminate extends to employment. Inquiries about the application of Title IX may be referred to the district’s Title IX coordinator, to the Assistant Secretary for Civil Rights of the Department of Education, or both.

Should be Empty:

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Chinese Simplified	Hungarian	Russian
Chinese Traditional	Indonesian	Slovak
Czech	Italian	Slovenian
Danish	Japanese	Spanish
Dutch	Klingon	Swedish
English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
German	Maltese	Vietnamese
Greek	Norwegian	Welsh
Haitian Creole	Persian

Arabic	Hebrew	Polish
Bulgarian	Hindi	Portuguese
Catalan	Hmong Daw	Romanian
Chinese Simplified	Hungarian	Russian
Chinese Traditional	Indonesian	Slovak
Czech	Italian	Slovenian
Danish	Japanese	Spanish
Dutch	Klingon	Swedish
English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
German	Maltese	Vietnamese
Greek	Norwegian	Welsh
Haitian Creole	Persian