PRINCIPAL / TEACHER APPLICATION

PRINCIPAL / TEACHER APPLICATION
CANDIDATE NAME
Are you eligible for employment in the United States?

YESNO
(Proof of citizenship will be required upon employment)
For the purposes of verifying past employment or other information on this application, please list other names used
We consider applicants for all positions without regard to age, race, color, sex, disability, national origin, or other bases protected by law. We shall be non discriminatory in employment practices in accordance to applicable federal and state laws insofar as they are consistent with the beliefs, official teachings, and doctrines of the Catholic Church. The employer may give preference to a Catholic applicant.

Applicants may request any needed accommodation to complete the application process.
SEND APPLICATION TO THE SCHOOL YOU ARE APPLYING
PARISH / SCHOOL NAME
DATE

MonthDayYear
Date
Address

ADDRESS

Street Address Line 2

CITYState / Province

ZIP
PERSONAL
Name

FIRST NAMEMIDDLE INITIALLAST NAME
EMAIL
example@example.com
PERMANENT ADDRESS:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
HOME PHONE
RELIGIOUS EDUCATION CERTIFICATION

NONEBASICINTERMEDIATEADVANCEDNOT SURE
RELIGIOUS AFFILIATION
BUSINESS PHONE:
POSITION APPLYING FOR

PRINCIPAL/ADMINISTRATORTEACHERTEACHER AND/OR SUBSTITUTESUBSTITUTE ONLY
DATE AVAILABLE FOR EMPLOYMENT

MonthDayYear
Date
SALARY DESIRED
ARE YOU UNDER CONTRACT?
FOR TEACHER APPLICANTS ONLY (CHECK ALL THAT APPLY)
ELEMENTARY SCHOOL

FULL-TIME TEACHERPART-TIME TEACHERSUBSTITUTE TEACHER
CIRCLE THE GRADES YOU PREFER TO TEACH:

PreschoolK12345678NO PREFERENCE
SECONDARY SCHOOL

FULL-TIME TEACHERPART-TIME TEACHERSUBSTITUTE TEACHER
CIRCLE THE GRADES YOU PREFER TO TEACH:

789101112NO PREFERENCE
HAVE YOU BEEN EMPLOYED BY A PARISH/SCHOOL IN THE ARCHDIOCESE OF MILWAUKEE IN THE PAST?

YESNO
IF YES, LOCATION(S)
EDUCATION

COLLEGE / UNIVERSITY

	NAME & LOCATION (City & State)	NUMBER OF CREDITS	DEGREE EARNED

CERTIFICATION

	LEVEL	TYPE OF CERTIFICATE (i.e., Life, 5 years)	STATE	DATE ISSUED

EMPLOYMENT (START WITH MOST RECENT)

	DATES FROM	DATES TO	ORGANIZATION (Address/City/State)	POSITION TITLE (Subject/Grade)	PRINCIPAL/SUPERVISOR’S NAME	REASON FOR LEAVING

MAY WE CONTACT CURRENT OR PAST EMPLOYERS?

YESNO
PROFESSIONAL ACTIVITIES
REFERENCES (GIVE RECENT ACADEMIC OR PROFESSIONAL REFERENCES)
NAME
WORKING RELATIONSHIP
ADDRESS
PHONE NUMBER
HOW DO YOU KNOW PERSON?
HOW LONG KNOWN PERSON?
NAME
WORKING RELATIONSHIP
ADDRESS
PHONE NUMBER
HOW DO YOU KNOW PERSON?
HOW LONG KNOWN PERSON?
NAME
WORKING RELATIONSHIP
ADDRESS
PHONE NUMBER
HOW DO YOU KNOW PERSON?
HOW LONG KNOWN PERSON?
HAVE YOU EVER BEEN CONVICTED OF, OR PLEAD GUILTY TO NOLO CONTENDERE TO, AN OFFENSE (INCLUDING FELONY, MISDEMEANOR OR MUNICIPAL ORDINANCE), OR ARE YOU NOW SUBJECT TO A PENDING CRIMINAL CHARGE?

YESNO
IF YES, DESCRIBE IN DETAIL (E.G. DATE; CONVICTION OR OFFENSE; LOCATION OF COURT)
CONVICTIONS OR PENDING CHARGES WILL BE CONSIDERED IN THE HIRING PROCESS ONLY TO THE EXTENT THEY SUBSTANTIALLY RELATE TO THE CIRCUMSTANCES OF EMPLOYMENT SOUGHT BY THE APPLICANT
DECLARATION
I hereby declare the information provided by me in this Application for Employment is true, correct and complete.

I hereby authorize the employer, schools, and persons named on this application to give any information requested regarding my employability, character, and qualifications, and release them from all liability for any damages for issuing this information.

I understand and agree that any misrepresentation, false statement, or omissions by me in this application will be sufficient reason for rejecting my application or for dismissal at any time during my employment without liability to my employer and/or the Archdiocese of Milwaukee.

I understand that, consistent with State regulation, I may be required to submit to, or provide evidence of, tuberculin testing and/or chest X-rays.
By signing my name below, I understand that nothing contained in this application or in the interview process is intended to create an employment contract.

By checking this box I have read and understand the above statements.
SIGNATURE
DATE

MonthDayYear
Date
By entering my full name, I attest that this constitutes my legal electronic signature on this form. REVISED 5/18
Should be Empty:

PRINCIPAL / TEACHER APPLICATION

SEND APPLICATION TO THE SCHOOL YOU ARE APPLYING

PERSONAL

FOR TEACHER APPLICANTS ONLY (CHECK ALL THAT APPLY)

EDUCATION

EMPLOYMENT (START WITH MOST RECENT)

REFERENCES (GIVE RECENT ACADEMIC OR PROFESSIONAL REFERENCES)

CONVICTIONS OR PENDING CHARGES WILL BE CONSIDERED IN THE HIRING PROCESS ONLY TO THE EXTENT THEY SUBSTANTIALLY RELATE TO THE CIRCUMSTANCES OF EMPLOYMENT SOUGHT BY THE APPLICANT

DECLARATION