Employment Forms

Employment Application

Personal Data
Full Name*

First NameMiddle NameLast Name
Social Security #*
Date Available to Start:*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Phone*
Secondary Phone
E-mail Address*
example@example.com

Education

	NAME OF SCHOOL	MAJOR/MINOR	DEGREE	YEAR GRADUATED
1.
2.
3.
4.

What was your grade point average in your major field of study during your Bachelor’s degree?
Overall g.p.a?

Certification(s)
Certificate or License(s) currently held:*

NoneTexas EmergencyValid TexasOther

Please list your areas of certification:

	Areas of Certification
1.
2.
3.
4.

Teaching Experience

Directions: Please list teaching experience beginning with the most recent years.

	NAME AND LOCATION OF SCHOOL	TYPE OF ASSIGNMENT	DATES TAUGHT	NUMBER YEARS	REASON FOR LEAVING
1.
2.
3.
4.
5.

Totals years of creditable educational experience:

Other Work Experience

Directions: Please provide a list of all other jobs or administrative positions you have held in the past 10 years. List the most recent first.*

	EMPLOYER/ LOCATION	POSITION/ TITLE	DATES EMPLOYED	REASON FOR LEAVING
1.
2.
3.
4.
5.

Totals years of creditable educational experience:

References

Directions: Please list references the district can contact regarding your work history. Please include all managers and supervisors who evaluated or supervised your performance at your last three places of work.*

	FULL NAME OF REFERENCE	RELATIONSHIP TO YOU	COMPLETE MAILING ADDRESS	POSITION/ TITLE	AREA CODE & PHONE
1.
2.
3.
4.
5.

Document Upload(s)
File Upload*

Cancelof
Please make sure you upload the following items:
- Cover Page
- Resume (Required)
- Certification(s)

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.It is understood that this application and all attachments included become the property of the Pegasus School.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 school is authorized by Texas Education Code 22.083 to obtain criminal history record information on applicants the school intends to employ.
Applicant Signature*

Clear

Pre-Employment Affidavit for Applicant

For the purposes of this affidavit:
Adjudication and conviction refer to a conviction, plea of guilty or no contest (nolo contendre), probation, suspension, or deferred adjudication.

Charge refers to a formal criminal charge as documented by a primary charging instrument (a complaint, information, or indictment) under the Texas Code of Criminal Procedure.

Inappropriate relationship refers to the crime of improper relationship between educator and student in Texas Penal Code section 21.12, and any other inappropriate relationship as determined by the State Board for Educator Certification.
I declare the following:*

I have never been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor.I have been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor. The charge, adjudication, or conviction was determined to be false.I have been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor. The charge, adjudication, or conviction was determined to be true.
The following are all of the relevant facts pertaining to the charge, adjudication, or conviction: (If applicable)
Declaration of Applicant

The following affidavit is offered to satisfy the requirement of Texas Education Code section 21.009 for a pre-employment affidavit, in accordance with Texas Civil Practices and Remedies Code section 132.001. An applicant who is offered employment will be asked to complete a notarized affidavit attesting to the same.
I declare under penalty or perjury that the foregoing is true and correct.
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Executed in _________________ County, State of ____________, on the _____ day of __________________ , 20_____ .
Signature of Declarant*

Clear
I understand that the date of birth I am providing will not be used to determine eligibility for employment but will be used solely for the purpose of this unsworn declaration.*

This form will be processed separately and not shared with the hiring manager.

Criminal History Verification Check
Notice: Criminal History Verification Check
Once you click submit, you will be redirected to complete the criminal history verification check forms and process for employment purposes. This is a required step for employment purposes.
Please verify that you have read this.*
Should be Empty:

Employment Application

Pre-Employment Affidavit for Applicant

Declaration of Applicant

Criminal History Verification Check