BBBSD Subsitute/Classified Job Application Form

Bristol Bay Borough School District

Classified/Substitute Employee Application Packet. Please complete the form below to apply for a position with us.
Date*

MonthDayYear
Date
Date Available to Begin Work*

MonthDayYear
Date
Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*
Position:*
How did you hear about us*
Please Specify
Available Start Date*

MonthDayYear

Record of Education

	High Schools Attended	Location (City, State, Zip)	Major or Area of Study	Graduate/Degree?
1
2

Record of Education

	College Attended	Location (City, State, Zip)	Major or Area of Study	Graduate/Degree?
1
2
3
4

Employment History

	Employer	Address	Phone	Dates
1

Job Duties and Duties Performed:

Employment History

	Employer	Address	Phone	Dates
2

Job Duties and Duties Performed:

Employment History

	Employer	Address	Phone	Dates
3

Job Duties and Duties Performed:
Skill/Experience Related to the Position:*

Personal References (Not former Employers or Relatives)*

	Name	Address	Email	Phone
1
2
3

Have you been involuntarily terminated, released or asked to resign from any employment within the last ten years? If you answer is "yes" please explain*
The following questions seek information regarding criminal convictions. For these purposes, the term “conviction” is intended to refer to any conviction, regardless of whether it resulted from a verdict or a plea of guilty or nolo contender and regardless of whether the conviction was subsequently overturned, set aside or expunged. The term “offense” is intended to encompass any level of offense including felony, misdemeanor and violation. Conviction of a crime is not an automatic bar for employment. The information you provide will be considered on a case-by-case basis.
Have you ever been convicted of a felony?
Have you ever been convicted of any offense involving sexual abuse, exploitation, or molestation of a minor or any other form of child abuse?
Have you ever been convicted of any offense involving contribution the delinquency of a minor?
Have you ever been convicted of any offense involving the use of abuse of alcohol, illegal drugs, or other controlled substances?
Have you ever been convicted of any offense involving physical injury to another person, threats. of physical injury, stalking or kidnapping?
Have you ever been convicted of any offense involving sexual assault or other sexual offense(including indecent exposure)?
Have you ever been convicted of any felony or misdemeanor involving destruction of property?
Have you been convicted of any violation involving destruction of property within the last ten years?
Have you ever committed any act that would constitute a crime or moral turpitude under the laws ofthe State of Alaska. (A crime of moral turpitude is a crime involving acts that are immoral or wrong inthemselves such as murder, sexual assault, robbery, kidnapping, incest, arson burglary, theft and forgery.)
RELEASE OF INFORMATION

I authorize release of all information pertaining to me from the records of educational institutions, military services, law enforcement agencies,

and present and past employers to my prospective employer, the Bristol Bay Borough School District.

As an applicant for a position with Bristol Bay Borough School, I have been requested to provide information for use in determining my qualifications for employment. In connection with my application. I authorize all previous employers and references to disclose to Bristol Bay Borough Schools any information that they have concerning my employment including, but not limited to, evaluations and other information contained in my personnel file.

I wave any claim to confidentiality that I might have in the information released, whether provided by AS 14.20 149(h) or by any other law, policy or contract provision, and release previous employers, their employees, agents and anyone acting on its behalf from any and all claims, liability and/or damages of any nature that may result from furnishing the information requested pursuant to this authorization.

A photocopy of this document shall be considered as valid as the original. The authorization to provide information pursuant to this document shall expire one year after the date of the signature below.

By signing this form, I verify that the information I have provided on this form and in connection with my application for employment is true and complete. I understand that any false statement on this form may be grounds for excluding me from consideration for employment or for dismissing me from employment, if the district employs me and subsequently learns of the falsity of a statement. I further understand that this application does not constitute either an offer or contract of employment, nor does it obligate the district in any way. I acknowledge that no one other that the superintendent has the authority to enter into an agreement of employment with me and that no such agreement can be made except in writing signed by the superintendent.
Done at City . State of State . Date Date of birth Date (for purposed of conduction of background check only)
Signature*

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Bristol Bay Borough School District