• Applicant Information

    Southwest School Corporation
  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Are you allergic to any medication?*

  • Employment Application

    Southwest School Corporation
  • Date*
     - -
  • Format: (000) 000-0000.
  • I am and will provide necessary documentation to validate that I am*
  • Position(s) Applying For*
  • Have you ever worked for this corporation before?*
  • Date available to start: *
     - -
  • Are you available to work:*
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  • Please indicate your source of referral:*

  • United States Military Service

  • Do you have United States Military Experience?*
  • Date Entered:
     - -
  • Date Discharged:
     - -

  • Education and Training:

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  • Work Experience

    List below your previous employers, starting with the most current one.
  • Format: (000) 000-0000.
  • Start Date
     - -
  • End Date*
     - -
  • Format: (000) 000-0000.
  • Start Date*
     - -
  • End Date*
     - -
  • Format: (000) 000-0000.
  • Start Date
     - -
  • End Date
     - -

  • Professional References

    Include three professional references who supervised your previous work (principals, supervisors, superintendents, etc.)
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  • Criminal Background Disclosure, Certification, and Authorization

    THIS SECTION MUST BE COMPLETED AS PART OF THE APPLICATION PROCESS. PLEASE MAKE CERTAIN THAT YOU ANSWER ALL OF THE QUESTIONS TRUTHFULLY. OMISSION OR FALSIFICATION OF ANY CRIMINAL INFORMATION WILL BE GROUNDS FOR IMMEDIATE DISMISSAL.
  • Have you ever been convicted of an offense other than a minor traffic violation?*
  • Have you ever been convicted of, had adjudication withheld, pled no contest to, or entered a pretrial intervention program for a misdemeanor or felony criminal charge?*
  • Have you ever been the subject of an indicated report by DCFS or similar state agency?*
  • Have you ever been suspended without pay, or dismissed from employment, or resigned while an investigation was in progress for possible disciplinary action?*

  • By signing below, I understand that the information provided is true and correct, and that any misstatements or omission of material facts in the application or the hiring process may result in discontinuing of the hiring process or termination of employment, no matter when discovered. I agree that the corporation shall not be held liable in any respect if my employment is terminated because of false statements, answers or omissions made by me in this application.

    I authorize the corporation to analyze the truthfulness of all statements made on this application, completereference checks from my current and former employers, and others that may provide information regarding my education and experiences. I also authorize a criminal background, sex offender, and other checks required by Federal and State government and the school code. I acknowledge that consideration
    for employment is contingent on the results of these background check(s). In addition, I give my consent for all contacted persons including current and former employers to provide information concerning this application, and I release each such person from liability for providing information to the corporation.

    I hereby attest that all statements made by me above are true to the best of my knowledge, and I agree to the terms noted above.

  • Date*
     - -
  • Are you applying to be a Substitute Teacher?*
  • Are you applying to be a Bus Driver?*
  • Are you applying for any of the following positions: Paraprofessional (Teacher's Aide), Bus Aide, Administrative Assistant or Treasurer*

  • Certified Position

    Complete this section if applying for any of the following: Teacher, Counselor, School Nurse or Administrator
  • Do you plan to apply for an of the following positions: Paraprofessional (Teacher's Aide) or Bus Driver
  • Are you currently under a contract to teach?*
  • Do you hold a valid Indiana License?*
  • What type(s):*
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  • School Bus Driver Position

    Please complete this section if applying for a School Bus Driver Position.

  • All driver applicants who currently possesss a Commercial Drivers LIcense (CDL) or whose position for the corporation would require a Commercial Drivers License (CDL) need to complete the section below.  DOT requires that employment for at least 3 yeras and/or commercial driving experience for the past 10 years be shown. 

  • Past Employers Requiring CDL:

  • Format: (000) 000-0000.
  • Start Date*
     - -
  • End Date*
     - -
  • Format: (000) 000-0000.
  • Start Date
     - -
  • End Date
     - -
  • Format: (000) 000-0000.
  • Start Date
     - -
  • End Date
     - -
  • Have you ever been involved in an accident while driving a school bus?*
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  • Have you ever been convicted of a traffic violations (other than parking violations)?*
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  • Are you at least 21 years of age or older?*
  • Have you ever been denied a license, permit or privilege to operate a motor vehicle?*
  • Has any license, permit or privilege ever been suspended or revoked?*
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  • I understand that any offers of employment may be contingent upon my taking and successfully passing a drug and/or alcohol test in accordance with Southwest School Corporation policy.  If I refuse to submit to testing, refuse to sign the corporation consent form, or test positive, the corporation will not employ me.  

  • Date*
     - -
  • Do you plan to apply to be a substitute teacher?*

  • Substitute Teaching Position

    Please complete the following section if applying for a Substitute Teaching Position.
  • Rows
  • Do you have a valid Indiana Substitute Teacher License?*
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  • Applying for Substitute Teacher License

    If you do not have a substitute teacher license, complete the steps below to apply.

  • If you do not already hold an Indiana substitute teaching license, please apply through the Indiana Licensing Verification and Information System (LVIS) at https://license.doe.in.gov/SignIn?returnUrl=%2F.

    Create or log in to your LVIS account, select Apply for a License, choose Substitute Permit, complete the application, upload any required documentation, and submit the licensing fee. You may log back into LVIS at any time to check the status of your application.

    See the user guide below for more detailed directions. 

  • Substitute Teacher Policy Acknowledgement and Agreement

  • ACKNOWLEDGEMENT, AGREEMENT, AND RECEIPT

    OF

    SUBSTITUTE TEACHER POLICY; DRUG FREE WORKPLACE POLICY; ANTI-
    HARASSMENT POLICY; STAFF TECHNOLOGY AND ACCEPTABLE USE AND
    SAFETY POLICY; USE OF SOCIAL MEDIA POLICY

    The undersigned hereby acknowledges receipt of a copy of the Substitute Teacher Policy; Drug-Free Workplace Policy; Anti-Harassment Policy; Staff Technology and Acceptable Use and Safety Policy; and Use of Social Media Policy. The undersigned hereby acknowledges and agrees that nothing contained in the policies including practices, and benefits stated herein are intended to create any contractual right, express or implied, to employment or to any particular term or condition of employment. We retain the right to revise, amend the policies or terminate any policies unilaterally without notice at any time and the Employee’s continued opportunity to work in Southwest School Corporation will be deemed acceptance of such revisions and modifications.

  • Date*
     - -

  • Acknowledgement of Mandated Reporter Status

    Southwest School Corporation

  • I understand that when I am working and/or volunteering for Southwest School Corporation in my official capacity and/or professional:

    I will become a mandated reporter under the Abused and Neglected Child Reporting Act (IC 31-33-5 and IC 12-17.2-3-5). This means that I am required to report or cause a report to be made to the child abuse and neglect hotline number at 1-800-800-5556 whenever I have reasonable cause to believe that there is or may be professional or official capacity may be abused or neglected. I understand that there is no other way of calling the hotline number and that the hotline operates 24-hours per day, 7 days per week, 365 days per year.

    I understand that in an effort to help mandated reporters understand their critical role in protecting children by recognizing and reporting child abuse/neglect, Department of Child Services administers an online training course, available 24 hours a day, seven days a week.

    I further understand that the privileged quality of communication between me and my patient or client is not grounds for failure to report suspected child abuse or neglect. I know that if I willfully fail to report suspected child abuse or neglect, I may be found guilty of a Class A misdemeanor. This does not apply to physicians who will be referred to the State for action.

  • Sign and date below to affirm that you have read this statement and have knowledge of the reporting requriements, which apply to me under the Abused and Neglected Child Reporting Act. 

  • Date*
     - -
  • Should be Empty: