St. Agnes Academy-St. Dominic School Employment Application

Mission Statement

St. Agnes Academy-St. Dominic School is a Catholic independent school, ecumenical by charter. The school was founded to educate young people in a principle-based program designed to prepare them for advanced formal and personal studies while deepening their faith and relationship with God.

In the Dominican tradition, the school actively encourages academic excellence and promotes spiritual and moral growth, social and ecological responsibility, leadership skills, multicultural awareness, emotional maturity, artistic expression, and physical fitness.

IF YOU ARE APPLYING FOR EXTENDED DAY (AFTER SCHOOL) OR SUMMER CAMP, CLICK HERE.

Date of Application

Date

GENERAL INSTRUCTIONS: You are requested to complete all of the fields with a red asterisk. If an item does not apply, enter N/A.

You will have the ability to upload copies of college transcripts, teaching certificate, resume, and cover letter, and submit application digitally.

For what position(s) are you applying:

Choose all that apply*

Please list subject(s), grade level(s), or non-teaching position(s) according to preference:

First* Second Third

Other subjects you are qualified to teach, or positions you are qualified to fill:

Full Legal Name*

First NameMiddle NameLast Name

Personal E-mail*

Home Number

Area CodePhone Number

Cell Number*

Area CodePhone Number

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Are you multilingual?

YesNo

(if yes, please list all languages)

Are you eligible to work in the United States*

YesNo

Has your driver's license ever been suspended or revoked?*

YesNo

(if yes, explain)

Have you ever been convicted of a felony or misdemeanor?*

YesNo

(if yes, explain)

Have you ever been charged with or convicted of child abuse or neglect?*

YesNo

(if yes, explain)

Have you ever been charged with physical or sexual abuse, or drug or alcohol-related offenses?*

YesNo

(if yes, explain)

Has your employment ever been terminated for any reason?*

YesNo

(if yes, explain)

Start with your present or most recent job. Include any job-related military service assignments and volunteer activities.

Please answer all questions with a red asterisk, type N/A if it does not apply.

Current or most recent employer:

Employer*

Employment Dates*

	Date Started	Date Ended
Employment Dates

Teaching Assignment/Job Title*

Address*

Phone No.*

Area CodePhone Number

Supervisor*

Wage/Salary*

Starting-Current/Final

Reason for Leaving*

Duties/Responsibilities*

Previous employer:

Employer

Employment Dates

	Date Started	Date Ended
Employment Dates

Teaching Assignment/Job Title

Address

Phone No.

Area CodePhone Number

Supervisor

Wage/Salary

Starting-Current/Final

Reason for Leaving

Duties/Responsibilities

Previous employer:

Employer

Employment Dates

	Date Started	Date Ended
Employment Dates

Teaching Assignment/Job Title

Address

Phone No.

Area CodePhone Number

Supervisor

Wage/Salary

Starting-Current/Final

Reason for Leaving

Duties/Responsibilities

High School*

Name & Address of School

Graduation Year*

Undergraduate College*

Name & Address of School

Course of Study Year Completed Type of Degree Earned

Graduate Professional

Name & Address of School

Course of Study Year Completed Type of Degree Earned

Other education:

Student Teaching:

Required if applying for a teaching position.

School Address Dates Grade(s)/Subject(s)

Teaching License:

State and Number:

Type:(Professional, Permanent, Temporary) Expiration:

Certification for grades:

In what subjects if for grades 7-12?

In what subjects do you have 12 or more semester hours?

Please describe any additional qualifications or skills...

Please provide a personal statement – Why do you wish to be employed at SAA-SDS?*

Upload College Transcripts

Upload a File

Upload Teaching Certificate

Upload a File

Upload Resume

Upload a File

Upload Cover Letter

Upload a File

Please list five persons other than relatives who are able to give information about your qualifications for the position for which you are applying.

1. Name Address Phone Position Email

2. Name Address Phone Position Email

3. Name Address Phone Position Email

4. Name Address Phone Position Email

5. Name Address Phone Position Email

How soon will you be available?*

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application may result in immediate termination.

I understand that a criminal background check will be conducted and my driving record will be requested and examined. I also understand that I will not be ocnsidered for employment if I ahve been charged with any of the following: drug offenses including possession, distribution, or use of controlled substance or drug paraphernalia, sexual offenses, larceny, violent acts, sexual assault, contributing to the deliquency of a minor, and driving under the influence of alcohol or drugs (DUI) within the last 5 years. I authorize St. Agnes Academy-St. Dominic School to conduct the aforementioned checks of my background and driving record. I also authorize the school to conduct random drug testing and understand that failue to pass such tests is grounds for immediate dismissal.

Signature*

Please sign in the box provided above. Use your mouse or finger pad on your computer, or simply sign using your finger on your phone or touch screen.

When you click on the "Continue" button below, you will see a copy of what you have filled out and will submit your application by clicking the button that says "Sign Document."

Date*

Name (printed)*

Thank you for your interest in St. Agnes Academy-St. Dominic School. Someone will get back with you shortly.

You will receive an email with the information you submitted and have the ability to download a pdf for your records.

For questions, please contact Beth Butler at bbutler@saa-sds.org.

Your application and accompanying documents will be automatically deleted after one year.

EMPLOYMENT HISTORY

QUALIFICATIONS/EDUCATIONAL BACKGROUND

REFERENCES