Employment Application Form
Apply to join our teaching and coaching team
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Date of Birth (Optional)
-
Month
-
Day
Year
Date Picker Icon
Social Security Number (Optional)
Education
High School - City/State
*
Graduation Year
*
College/University - City/State
Graduation Year
Degree
Associates
Bachelor's
Master's
Other
Minors/Majors - GPA
Would you like to add a second degree?
Yes
No
College/University - City/State
Graduation Year
Degree
Associates
Bachelor's
Master's
Other
Minors/Majors - GPA
Would you like to add a third degree?
Yes
No
College/University - City/State
Graduation Year
Degree
Associates
Bachelor's
Master's
Other
Minors/Majors - GPA
Desired Positions that apply)
*
Teacher
Administration
Coach
Teaching Assistant
Cafeteria Worker
Custodian
Substitute Teacher
Bus Driver
Other
Desired Administrative Position(s)
*
Superintendent
Director of Curriculum and Instruction
JSHS Principal
JSHS Assistant Principal
Elementary Principal
Elementary Assistant Principal
Athletic Director/Director of Transportation
Director of Literacy
Director of Integration
Level of Teaching? (Click all that apply)
*
Elementary K-6
Junior High 7-8
High School 9-12
Interest in what content areas to teach?
*
Do you currently hold a valid Indiana Teaching License
*
Yes
No
List your licensed content areas?
*
Please upload copy of license at the end of the form.
Teaching Experience Years in Education
*
0-2 Years
3-5 Years
5-10 Years
11-20 Years
20-30 Years
30+
Administrative Experience Years in Education
*
0-2 Years
3-5 Years
5-10 Years
11-20 Years
20-30 Years
30+
Student Teaching Experience
Within the last three school years, please complete
School Building(s)
*
School Corporation(s) (City/State)
*
Administrator(s)
*
Grade(s)/Subject(s)
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Supervising Teacher(s)
*
Administration Experience
Most recent first, please
School Corporation
*
School Building
*
Supervisor Name
*
Position Held
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Telephone number
*
May we contact?
*
Yes
No
Reason for leaving
*
Would you like to add a 2nd Administrative Experience?
*
Yes
No
School Corporation
*
School Building
*
Supervisor Name
*
Position Held
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Telephone number
*
May we contact?
*
Yes
No
Reason for leaving
*
Would you like to add a 3rd Administrative Experience?
*
Yes
No
School Corporation
*
School Building
*
Supervisor Name
*
Position Held
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Telephone number
*
May we contact?
*
Yes
No
Reason for leaving
*
Teaching Experience
Most recent first, please
School Corporation
*
School Building
*
Supervisor Name
*
Grade(s)/Subject(s)
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Telephone number
*
May we contact?
*
Yes
No
Reason for leaving
*
Would you like to add a 2nd Teaching Experience?
*
Yes
No
School Corporation
*
School Building
*
Supervisor Name
*
Grade(s)/Subject(s)
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Telephone number
*
May we contact?
*
Yes
No
Reason for leaving
*
Would you like to add a 3rd Teaching Experience?
*
Yes
No
School Corporation
*
School Building
*
Supervisor Name
*
Grade(s)/Subject(s)
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Telephone number
*
May we contact?
*
Yes
No
Reason for leaving
*
Would you like to add a 4th Teaching Experience?
*
Yes
No
School Corporation
*
School Building
*
Supervisor Name
*
Grade(s)/Subject(s)
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Telephone number
*
May we contact?
*
Yes
No
Reason for leaving
*
Would you like to add a 5th Teaching Experience?
*
Yes
No
School Corporation
*
School Building
*
Supervisor Name
*
Grade(s)/Subject(s)
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Telephone number
*
May we contact?
*
Yes
No
Reason for leaving
*
U.S. Military Experience?
*
Yes
No
Branch of Service
*
Please Select
Army
Navy
Marine Corps
Air Force
Space Force
Coast Guard
Technical Specialization
Rank Attained
*
Years of Service
*
Coaching Interest
Interest in coaching Boys and/or Girls - What Sport(s) and What Level(s)
*
Coaching Experience
School Corporation/Program
*
School Building/Location
*
Supervisor Name
*
Telephone number
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Teams/Level/Years coached
*
Championships/Awards
*
May we contact?
*
Yes
No
Reason for leaving
*
Would you like to add a 2nd Coaching Experience?
*
Yes
No
School Corporation/Program
*
School Building/Location
*
Supervisor Name
*
Telephone number
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Teams/Level/Years coached
*
Championships/Awards
*
May we contact?
*
Yes
No
Reason for leaving
*
Would you like to add a 3rd Coaching Experience?
*
Yes
No
School Corporation/Program
*
School Building/Location
*
Supervisor Name
*
Telephone number
*
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Teams/Level/Years coached
*
Championships/Awards
*
May we contact?
*
Yes
No
Reason for leaving
*
Other Relevant Coaching Experiences
*
Work Experience - Non-Certified
Position
*
Employer
*
Supervisor Name
*
Telephone number
*
Address
*
May we contact?
*
Yes
No
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Reason for leaving
*
Do you have a CDL?
*
Yes
No
Types of CDL licenses or certifcations? Choose all that apply.
Class A
Class B
Class C
Passenger Endorsement (P)
School Bus Endorsement (S)
Tank vehicle endorsement (N)
Hazardous materials endorsement (H)
Tanker/HazMat combination endorsement (X)
Doubles/triples endorsement (T)
Would you like to add a 2nd Work Experience?
*
Yes
No
Work Experience - Non-Certified 2
Position
*
Employer
*
Supervisor Name
*
Telephone number
*
Address
*
May we contact?
*
Yes
No
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Reason for leaving
*
Would you like to add a 3rd Work Experience?
*
Yes
No
Work Experience - Non-Certified 3
Position
*
Employer
*
Supervisor Name
*
Telephone number
*
Address
*
May we contact?
*
Yes
No
Starting Date
*
-
Month
-
Day
Year
Date Picker Icon
Ending Date
*
-
Month
-
Day
Year
Date Picker Icon
Reason for leaving
*
References
Please list three (3) individuals we may contact who know your background and qualifications. Do not list relatives.
Name
*
Relationship
*
Address
*
Telephone number
*
Name
*
Relationship
*
Address
*
Telephone number
*
Name
*
Relationship
*
Address
*
Telephone number
*
Other Relevant Work Experiences
*
Availability
Date when you would be available to work?
*
-
Month
-
Day
Year
Date Picker Icon
Are you at least 18 years of age?
*
Yes
No
Please list the type of work you are looking for:
*
Full Time
Part time
Substitute
Please list any days/shifts that you would be unable to work?
*
Are you related to anyone in the employ of North Daviess Community Schools?
*
Yes
No
If yes, please list name, title, and school location:
*
Criminal Record
Have you ever been convicted of a felony?
*
Yes
No
If you answered yes to the above question, please explain:
*
With respect to your present or most recent employer, did you or have you offered a resignation from thatposition?
*
Yes
No
With respect to that employer, were you ever considered for discipline or discharge due to your alleged conduct or misconduct? If yes, please explain the circumstances on a separate sheet and attach to this application.
*
Yes
No
Have you ever been reprimanded, disciplined, discharged, or asked to resign from a prior position?
*
Yes
No
Have you ever resigned from a prior position without being asked, but under circumstances involving youremployer’s investigation of sexual contact with another person, of mishandling funds, or of criminal conduct? Ifyes, explain the circumstances on a separate sheet and attach to this application.
*
Yes
No
Have you ever been charged with or investigated for sexual abuse of another person?
*
Yes
No
Have you (a) ever been convicted of a crime, other than a minor traffic offense; or (b) ever entered a plea of guilty or a plea of “no contest” (nolo contendere), or has any court ever deferred further proceedings without entering a finding of guilty and placed you on probation, for any crime other than a minor traffic offense?
*
Yes
No
Have you ever been charged with, pleaded guilty or “no contest” (nolo contendere) to, or been convicted of anycrime involving sexual abuse of any person or any other crime of moral turpitude? (Moral turpitude is an act ofbaseness, vileness, or depravity in the private and social duties which a person owes another member of society or society in general and which are contrary to the accepted rule of right and duty between persons, including, butnot limited to theft, attempted theft, murder, rape, swindling and indecency with a minor.)
*
Yes
No
If you have answered yes to any one of the previous three questions, please explain, in detail, including the date of the charge, the court action, the offense in question, and the address of the court involved.
*
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of
North Daviess Community Schools does not discriminate on the basis of race, creed, color, sex, religion, national or ethnic origin, age, or disability. I hereby certify that the information found within this application has been provided voluntarily and I waive any right to assert discrimination on the basis of that which has been divulged. I hereby authorize all persons, firms, corporations, educational institutions, and organizations of any kind to release to the North Daviess Community School Corporation any and all information, files or records pertaining to application, and to permit inspections, and to furnish copies of any documents pertinent to this application. I further authorize any and all persons in any capacity to answer any and all questions in any form that may be submitted to them concerning this application. I understand that my application will remain in the Central Office files for one (1) year, and all materials accompanying this application will become the property of North Daviess Community Schools. I certify there are no misrepresentations in or falsifications of these statements and answers. I am aware that should investigations disclose such, my application may be disqualified, my name removed from all eligible lists, and my future applications may not be accepted. I am also aware that falsification of this application, or any accompanying data, may result in my dismissal from any position with North Daviess Community Schools. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the North Daviess Community School Corporation. I expressly waive in connection with any request for or provision of such information, any claims, including without limitations, defamation, emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against the North Daviess Community School Corporation, its agents and officials or against any provider of such information. Signature of Applicant:
*
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