Sargent Non-Certified Application

To Applicant:

Sargent School District RE-33J is seeking high quality candidates. Please submit the following items with this application to complete your file and be eligible for interview:

1. Letter of application

2. Resume

The Sargent School District does not unlawfully discriminate on the basis of race, color, sex (which includes marital status), sexual orientation, religion, national origin, ancestry, creed, age, or disability in admissions, access to, treatment, or employment in educational programs or activities which it operates. Specific complaints of alleged discrimination under Section 504 (handicap), Title II (Disability) or Title IX (sex) should be referred to: Superintendent of Schools, Sargent School District, 7090 N. Road 2 E., Monte Vista, Colorado 81144, phone (719) 852-4023. Complaints may also be filed with the Office of Civil Rights, U.S. Department of Education, Region VIII, Federal Office Building, 1244 North Speer Boulevard, Suite 310, Denver, Colorado 80204.
Resume Upload*

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Name*

First NameMiddle NameLast Name
Position Applying For*
Phone Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Service in Related Field:*
High School Attended?*
Graduated?*

YesNoGED

Education or Training Beyond High School

	School/Facility	Date From-To
.
.
.

Present Position & Supervisor's Name and Address

Past Working Experience

	Position	Employer	Date From/To	Reson for Leaving	Supervisor Name and Contact Number
.
.
.
.

Could you come in for an interview?*

YesNo
Date you are available to start*
I am qualified for the job sought as a result of the following educational, occupational, and professional skills:
Have you ever been dismissed from a position or asked to resign?*

YesNo
If “Yes”, where, and describe reasons (attach a separate sheet if necessary.)
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References

Please list two (2) references that are familiar with your work life.
Reference*
Reference*
Applications are placed in the active file for a period of one (1) year.

An on-site interview (at the applicant’s expense) is required before hiring, unless specifically waived by the district.

Colorado statutes provide that this application and the information contained herein are available for public inspection.
PLEASE READ CAREFULLY BEFORE SIGNING

Every non-certified individual hired by the district will have the following background checks completed:

Fingerprinting

1. As a prerequisite to employment, all applicants hired by the Board of Education for support staff positions must submit a complete set of fingerprints taken by a qualified Colorado Applicant Background Services Vendor and an Oath and Consent Form as required by state law. The district office will provide the employee with the fingerprint directions, these directions are strictly for Sargent School District, no other form of backgound check will be accepted.

2. On the following oath form the applicant must certify either that he/she has never been convicted of a felony or misdemeanor charge, not including any misdemeanor traffic offense, or that he/she has been convicted of a felony or misdemeanor (not including any misdemeanor traffic offense). The certificate must specify the felony or misdemeanor, the date of conviction and the court entering judgment.

3. Although an applicant may be conditionally employed prior to receiving the results, he/she may be terminated if the results are inconsistent with the information provided on the form.

4. The applicant will be responsible for all fees for fingerprint processing. Arrangements may be made through the district office for payroll deduction for payment.

A false statement on any part of your application may be grounds for not hiring you, or firing you after you begin work.

I certify that, to the best of my knowledge and belief, all of my statements are true, correct, complete and made in good faith.
Signature*

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Date*

MonthDayYear
Date
Oath and Consent Form

All questions must be answered. All documents requested must accompany this application.

To be completed by applicant.
Name*

First NameMiddle NameLast Name
Maiden/Former Name
Have you ever been convicted of a felony or misdemeanor (other than a misdemeanor traffic offense or traffic infraction)?*

YesNo
If yes, please include with your application a copy of the police report, and copies of the charging document and disposition document from the court for each conviction.

For the purposes of this question, "convicted" is defined as the occurrence of ANY of the following in connection with a criminal charge:

1. A finding of guilty by a jury or court.

2. A court's acceptance of a plea of guilty or a plea of nolo contendere.

3. A court's imposition of a deferred or suspended sentence.

4. A court's approval of an agreement for a deferred prosecution.

5. Forfeiture of a bail, bond, or other security deposited to secure a defendant's appearance.

6. Payment of a fine.

Please specify the offense(s) for which you were convicted, along with the date of conviction and the court entering the judgment of conviction/

	Offense	Felony/Misdemeanor	Conviction Date	Court Location
.
.
.

Accompanying Documents:

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OPTIONAL SECTION: From time to time, surrounding school districts experience a shortage of candidates and will contact us for leads on applicants. If you want us to share your file with districts which are seeking applicants in your area of specialization, please sign the following release:

I hereby authorize sharing of my application data, including but not limited to credentials and transcripts, with authorized employment officials from other school districts who may be seeking applicants in my area of specialization.
Signature

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Date

MonthDayYear
Date
AFFIRMATIVE ACTION EMPLOYMENT DATA

The Sargent School District is an Equal Opportunity/Affirmative Action Employer. In an effort to collect and analyze data for affirmative action purposes only, you are invited to complete this form by providing the information requested below. The provision of the information is strictly voluntary, and, if provided, this information will be handled confidentially. Failure to provide this information will not subject you to any adverse treatment. Upon request, reasonable accommodation to handicapped applicants may be made.
Ethnic Information

American Indian or Alaskan NativeAsian or Pacific IslanderBlack, not of Hispanic OriginHispanicWhite, not of Hispanic Origin
Gender Information

FemaleMale
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