Coaching Employment Application
Dock Mennonite Academy, a private Christian school with campuses in Lansdale & Souderton, PA, serves students EC -Grade 12, fostering academic and athletic excellence. Dock.org|Dockathletics.org
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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example@example.com
Phone Number
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Format: (000) 000-0000.
Employment Desired
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At which level are you interested in coaching?
Middle School (MS)
High School (HS)
No preference / willing to coach either
Date available for employment
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Are you employed now?
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If yes, may we contact your current employer?
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Yes
No
Not Yet
Education/Experience
Educational Background - present or most recent first, including high school
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Resume (please include experience) and Files
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Identify the kinds of qualities and skills you would be bringing to the job that would qualify you for this position. Also, give the one area that you feel least qualified for in this position.
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Faith Perspective
Please list the church you attend
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Are you a member?
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Yes
No
Denomination
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How would your employment at Dock Mennonite Academy be related to or expressive of your Christian faith?
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General Background Information
Were you ever convicted of a criminal offense?
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Yes
No
Are you currently under charges for a criminal offense?
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Yes
No
Have you ever forfeited bond or collateral in connection with a criminal offense?
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Yes
No
Within the last 10 years, have you been fired from any job for any reason?
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Yes
No
Within the last 10 years, have you quit a job after being notified that you were being fired?
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Yes
No
Have you ever been professionally disciplined in any state?
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Yes
No
Are you subject to any visa or immigration status which would prevent lawful employment?
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Yes
No
If you answered yes to any of the questions above, please provide an explanation:
References
Please list three (3) references that are familiar with your work life. References could include a pastor, non-relative who has known you for many years, work supervisor, professors, etc. If any person(s) listed should not be contacted for reference at the present time, please indicate that in the notes section.
Reference
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Reference
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Reference
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CERTIFICATION AND RELEASE AUTHORIZATION
I certify that all of the statements made by me are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I further certify that I am the sole author of the essay. I understand that any misrepresentation of information shall be sufficient cause for: (1) rejecting my candidacy, (2) withdrawing of any offer of employment, or (3) terminating my employment. I hereby authorize any and all of my previous employers and/or supervisors to release any and all of my personnel records, and to respond fully and completely to all questions that officials of Dock Mennonite Academy may ask regarding my prior work history and performance. I will hold such previous employers and/or supervisors harmless of any and all claims that I might otherwise have against them with regard to statements made to this school district. I further authorize these officials to investigate my background, now or in the future, to verify the information provided and release from liability all persons and/or entities supplying information regarding my background. However, I do not authorize the production of medical records or other information which would tend to actually identify a disability nor do I authorize inquiries which would include information related to any medical condition or medical history. Further, I do not waive any rights which I may have under state or federal law related to my right to challenge the disclosure of unlawful or inaccurate information, whether by the school district or by entities or persons providing such information to the school district, including any and all claims concerning allegations of employment discrimination because of race, color, sex, religion, national origin, ancestry, age or disability.
Signature
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