Classified Staff Application

CLASSIFIED STAFF APPLICATION

Please complete this form.
Personal Information
Name*

First NameMiddle NameLast Name
Other name under which transcripts, certificates, and former applications may be listed:
Example: maiden name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
This will be used to communicate with you.
Home Phone Number*
Please enter a valid phone number. This will be used to communicate with you.
Cell Phone Number (Optional)
Please enter a valid phone number. If completed, this will be used to communicate with you.
Position(s)
List the position(s) you are applying for: *
What is your available start date?*

MonthDayYear
Date
What type of position(s) are you interested in?*

Full-TimePart-TimeSubstitute

Employment History

List by most current.
How many previous experiences would you like to submit with your application?*
Employer 1: Company Name & Address*
Position(s) Title/Role*
Date Range Employed*
Reason for Leaving*
Job Notes & Tasks Performed*
Employer 2: Name & Address*
Position(s) Title/Role*
Date Range Employed*
Reason for Leaving*
Job Notes & Tasks Performed*
Employer 3: Name & Address*
Position(s) Title/Role*
Date Range Employed*
Reason for Leaving*
Job Notes & Tasks Performed*
Education
What is the highest grade you completed?*
Example: 12th Grade
What is the highest college degree you have obtained?*
Example: Bachelor's Degree

References

Please provide up to TWO references.
How many references would you like to submit with your application?*
Reference 1*
Name of Reference 1
Relationship to You*
Contact's Phone Number*
Please enter a valid phone number.
Contact's Email*
example@example.com
Reference 2*
Name of Reference 2
Relationship to You*
Contact's Phone Number*
Please enter a valid phone number.
Contact's Email*
example@example.com
Reference 3*
Name of Reference 3
Relationship to You*
Contact's Phone Number*
Please enter a valid phone number.
Contact's Email*
example@example.com
Reference 4*
Name of Reference 4
Relationship to You*
Contact's Phone Number*
Please enter a valid phone number.
Contact's Email*
example@example.com
Candidate Statements

(500 words or less)
Please watch our Vision Culture video before answering the questions below.

Video Link: www.youtube.com/watch?v=CQ6sNORweHo

Vision Culture Graphic: https://drive.google.com/file/d/1yDrVQLa91PbZJqwQGHTtaoGhBXtOXfpi/view
Why Oskaloosa Schools?*
After watching our Vision Culture video, how does this align to your own values and actions?*
How did you hear about Oskaloosa Schools and/or the position(s) you are applying for?*
Disclosures

Please note: Applicants are not obligated to disclose sealed or expunged records.
Have you ever served in the Military?*

YesNo
Have you ever been convicted of a crime other than traffic violations?*

YesNo

Legal Information, Consent & Acknowledgment
I consent and acknowledge that any background check information obtained during this hiring and application process may be used in making any final determination for hiring.
Signature*

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It is the policy of the Oskaloosa Community School District not to discriminate in educational programs on the basis of race, creed, color, gender, sexual orientation, marital status, gender identity, socioeconomic status, national origin, religion, disability, age (except for permitting/prohibiting students to engage in certain activities) or genetic information and in employment opportunities on the basis of age, race, creed, color, gender, sexual orientation, gender identity, national origin, religion, disability or genetic information. There is a grievance procedure for processing complaints of discrimination. If you have questions or a grievance related to this policy, please contact Marcia DeVore Director of Teaching and Learning (devorem@oskycsd.org), 1800 North 3rd Street, Oskaloosa, Iowa 52577 641 673-8345

I hereby authorize reference checks, background investigations, and former employers to release information.

I hereby certifiy the information given in this application is correct and true.

By typing my name I acknowledge, consent, and agree to all the terms previously stated.
Print Name*
Date*

MonthDayYear
Date
Signature*

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CLASSIFIED STAFF APPLICATION