Ridgeview Global Studies Academy Employment Application

Notice to all applicants

After submitting form please follow-up by emailing resume to Ralph H. Frier Executive Director at ralph.frier@polk-fl.net as well as faxing resume to 863-419-3199.
Personal Information
Full Name

First NameLast NameSuffix: Jr,Sr, Etc.
Sex

MaleFemale
Social Security Number*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
Work Phone*
Home Phone*
Are You a United States Citizen?*

YesNo
Are you retired from a Florida Retirement System?*

YesNo
Please select any/all of the positions that you are applying for at this time.
Education Information
Name of High School you attended
High School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of College or University you attended
College or University

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Degree Received and Date
Names of other schools you have attended
Other Schools Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Degree Received and Date
Employment History
Start date

MonthDayYear
End Date

MonthDayYear
Still Working for Employer 1

YesNo
Name of Employer 1
Employer 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer 1 Phone

Area CodePhone Number
Employer 1 Supervisor
Reason for Leaving
Name of Employer 2
Start date

MonthDayYear
End Date

MonthDayYear
Still Working for Employer 2

YesNo
Employer 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer 2 Phone

Area CodePhone Number
Employer 2 Supervisor
Reason for Leaving
Name of Employer 3
Start Date

MonthDayYear
End Date

MonthDayYear
Still Working for Employer 3

YesNo
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Reason for Leaving
Do you Currently hold a valid Florida Educator's Certificate

YesNo
Have you ever had a teaching certificate suspended or revoked by the State of Florida or any other State

YesNo
Are you under contract with any school system at this time

YesNo
If Yes, Name of School System
Please list other states in which you hold a valid teaching certificate
Please list at least 3 References
Name of Reference 1
Reference 1 Phone Number
Name of Reference 2
Reference 2 Phone Number
Name of Reference 3
Reference 3 Phone Number
Have you ever been arrested and/or convicted, found guilty, had adjudication withheld, or entered a plea of nolo contendre (no contest) to a crime other than a minor traffic violation? (DUI is Not a minor traffic violation) Florida Law requires a YES or NO answer. Please attach a certified copy of legal disposition and/or court document related to each arrest. Any record that has not been sealed or expunged must be reported must be reported in this section.*

YesNo
If Yes, Dates, Where, When did arrest take place?
I hereby represent that each answer to a question herein and all other information otherwise furnished is true, complete, and correct. I further represent that such answers and information constitute a full and complete disclosure of my knowledge with respect to the question or subject to which the answer of information relates. I understand that any incorrect, or incomplete, or false statements or information furnished by me will subject me to discharge at any time. In the event that I am employed by Ridgeview Global Studies Academy, I agree to comply with all rules and regulations, I hereby authorize my former employers to give any information regarding my employment with them and in addition to furnish any other information they have concerning me. I understand that I will participate in a drug screening when offered employment and that I must have a negative drug screen results to be employed. If my drug screen is positive, I understand that I may not be considered for employment for one year after the date of the positive test. I understand that I will be fingerprinted as a matter of protection and identification, and will be on probationary status pending fingerprinting processing and payment of fees associated with the fingerprinting process. I will have a physical exam by a qualified physician as a condition of employment. I authorize the release of all information from any and all law enforcement agencies where protected under the Privacy Act. All information contained in the applicant's file is public information subject to inspection under Public Records Act, Florida Statute 119.07, unless specifically excluded from the Public Records Act, under Florida School Law 1012.31. It is the policy of Ridgeview Global Studies Academy not to discriminate against employees or applicants for employment on the basis of race, color, religion, sex, national origin, marital status, age, or disability. Sexual harassment is a form of employee misconduct, which underminds the integrity of the employment relationship, and is prohibited. This policy shall apply to recruitment, employment, transfers, compensation, and other terms and conditions of employment. I have read and fully understand this agreement and it's contents.*

YesNo
Should be Empty:

Notice to all applicants

Personal Information

Education Information

Employment History

Please list at least 3 References