Aquilla ISD APPLICATION FOR PROFESSIONAL PERSONNEL

APPLICATION FOR PROFESSIONAL PERSONNEL

An Equal Opportunity Employer
Email1
example@example.com
Email2
example@example.com
Email3
example@example.com
Email4
example@example.com

Personal Data
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.
Cell phone
Please enter a valid phone number.
Other phone
Please enter a valid phone number.
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*
(Used for certification, reference, and criminal history record checks)
Credentials included with application:

RésuméAll teaching and professional certificates or licensesAll transcripts showing degrees
Please Upload

Cancelof
Please Upload

Cancelof
Date you can begin work*

MonthDayYear
Date
Have you been employed by {schoolName} the district in the past?

YesNo
Provide date of employment*

MonthDayYear
Date

Education/Training

Education/Training

	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

Certification/Licensure
Certificates or Licenses Currently Held:

NoneValid TexasValid Other StateTexas One-Year (out-of-state/country)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):

	Describe
1
2
3
4
5
6

Teaching Experience

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.
Reason for leaving
Do you have additional teaching experience to add?

YesNo
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.
Reason for leaving
Do you have additional teaching experience to add?

YesNo
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.
Reason for leaving
Do you have additional teaching experience to add?

YesNo
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.
Reason for leaving
Do you have additional teaching experience to add?

YesNo
Upload all additional work experience

Cancelof

Other Work Experience
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.
Reason for leaving
Do you want to add another work experience?

YesNo
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.
Reason for leaving
Do you want to add another work experience?

YesNo
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.
Reason for leaving
Do you want to add another work experience?

YesNo
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.
Reason for leaving

References

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

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

General Information
Do you have a relative who serves on the Board of Education or is an employee of {schoolName}?

YesNo
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)?

YesNo
Please state where, when, and the nature of the offense

Verification
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 sub sequent employment.I authorize the references listed on the previous page 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*

Clear
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.

Submit
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English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
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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