Employment/Substitute Teacher/Volunteer Application & Background Check Authorization

Employment/Substitute Teacher/Volunteer Application & Background Check Authorization
Position Desired:*
Date Available for Work: *

MonthDayYear
Date
Personal Information:
Legal Name*

First NameLast Name
Preferred Name

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you lived at this address? *
Email*
example@example.com
Relationship Status
Spouse's Name

First NameLast Name
Desired Level(s):*

Kindergarten1st-4th Grades5th-6th Grades7th-8th Grades9th-12th Grades
Grade or subject in order of preference:*
Please list activities or sports that you would be capable of and interested to direct, sponsor, advise, or coach: *
Have you ever been dismissed, resigned to avoid being dismissed, or been asked to resign from a position?*

YesNo
If yes, explain:
Have you ever been convicted of any offense involving dishonesty, breach of trust, child abuse, or any felony?*

YesNo
If yes, explain:
What sparked your interest in teaching at CMA?*
Do you know people who attend CMA or work for CMA?*

References
Please give three personal/pastoral references who are qualified to speak of your spiritual experience and Christian service.
Reference (1) *

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Occupation*
Reference (2)*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Occupation*
Reference (3)*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Occupation*
Please give three professional references who are qualified to speak to your professional training and or experience. List your current or most recent principal or supervisor first.
Reference (1)*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Occupation*
Reference (2)*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Occupation*
Reference (3)*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Occupation*
Professional Qualifications:

If you hold a degree, please list your information below.
What degree(s) do you hold?
Date Received

MonthDayYear
Date
Issuing Institution
Your Major(s)
Your Minor(s)
Cumulative Grade Point Average:
Graduate:
Undergraduate:

Teaching Experience

Please list your teaching experience with the most recent first:
Place
Grade/Subject
Dates
Club/Sports
Place
Grade/Subject
Dates
Club/Sports
Place
Grade/Subject
Dates
Club/Sports
Number of years teaching experience:
Public:
Private:
Christian:
Total:
Are you under contract for the coming year?

YesNo
Reason for leaving your most recent position?
List other work or military experiences that may have significance for the type of position for which you are applying:
Place
Type of Work/Experience
Dates
Do you have a state teaching certificate?*

YesNo
What kind?
Expires:
Endorsement(s) List semester hours in endorsement area(s)
If you do not hold a license, what requirements do you lack?

Personal Interests:
List memberships, offices, and honors obtained in:
High School:
College:
Current:
List your hobbies and personal interests:
Christian Background:
Church Denominational preference:*
What church do you attend?*
Are you presently a member in good standing?*
How many years have you attended this church? *
In what church activities are you involved in and with what degree of regularity?*
What ministry or service have you been involved in?*
Describe your routine of personal Bible study and prayer:*
Other than the Bible, what books have most influenced you?*
Please comment on your spiritual growth:*
List current strengths:*
List current weaknesses:*

Private Religious Organization Disclosure
As a private Christian school, CMA is a “religious organization.” While commerce laws prohibiting arbitrary discrimination on the basis of race, color, sex, national origin, age and disability apply generally to religious organizations, a religious organization is allowed to discriminate on the basis of its religious beliefs. This exception is rooted in the constitutional right to free exercise of religion. As a private school, CMA considers academic performance to be a criteria relevant to decisions regarding student admission and retention. As a religious organization, CMA will neither commence nor continue admission, enrollment or employment if it is believed by CMA that such will cause confusion about, conflict with, or compromise of the school’s mission to provide a distinctly Christian education from a Christ-centered worldview. In that regard, CMA conforms to the orthodox teachings of the historical Christian Church as set forth in the sixty-six books of the Holy Bible, all of which we believe to be our infallible and authoritative rule of faith and practice. Any decision to discriminate on the basis of religious belief will be made by School Administration. This policy applies to and is incorporated into all CMA affairs, including all CMA contracts, programs, activities, facilities, publications, and events.
Expectations for CMA Team Members
Team members of CMA, substitute teachers and recruited volunteers work separately and together in response to a calling from God to advance and accomplish the CMA mission to serve families, churches and the community by providing a K-12th grade education, characterized by excellence in the pursuit of truth from a Christ-centered worldview. As such, CMA team members are persons responsible for defining, cultivating, leading and/or representing CMA, all as an expression and exercise of our agreed Christian community beliefs. Having a common mission, each CMA team member is an integral part of CMA and CMA expects each team member to comply with the following obligations:

Christian Beliefs. Each CMA Team Member shall affirm agreement with the beliefs of CMA as expressed in the Doctrine Statement. CMA team members shall not subscribe to or promote any religious beliefs inconsistent with such beliefs. Each CMA team member must affirm that his or her calling to serve at Christian Ministries Academy requires him or her to respect such beliefs and to abide by CMA standards regarding the exercise or expression of such beliefs. “How can two walk together unless they be agreed?” Amos 3:3.

Christian Conduct. Each CMA Team Member shall at all times (during working and non-working hours) model said beliefs as listed in the CMA Mission Statement and Doctrinal Statement.
Statement of Doctrines
While we are interdenominational, doctrinally, we hold to these basic fundamental teachings of the Bible, God’s Word:

1. The inspiration of the Bible, equally in all parts and without error in its origin.
2. The one God, eternally existent Father, Son, and Holy Spirit, who created man by a direct immediate act.
3. The pre-existence, incarnation, virgin birth, sinless life, miracles, substitutionary death, bodily resurrection, ascension to heaven, and the second coming of the Lord Jesus Christ.
4. The fall of man, the need of regeneration by the operation of the Holy Spirit on the basis of grace alone, and the resurrection of all; to life or damnation.
5. The spiritual relationship of all believers in the Lord Jesus Christ, living a life of righteous works, separated from the world, witnessing of His saving grace through the ministry of the Holy Spirit.
I fully support the CMA Doctrinal Statement as written above without reservations.*

YesNo
Date*

MonthDayYear
Date
Applicant's Certification and Agreement:
I understand that this school does not discriminate in its employment practices against any person because of age, race, color, national or ethnic origin, gender, or handicap. I further understand that any offer of employment is conditioned on the proof of legal authority to work in the U.S.
I also recognize, understand, and adhere to the moral and ethical standards and mandates of this school. I further declare that with regard to my personal moral and ethical character and conduct as of this date, I am not, nor have been in the past engaged in inappropriate conduct toward minors, nor do I have inclinations toward such conduct. I fully agree with the school’s Policy and Statement in its entirety and further agree to model these standards as a representative of the school should I become employed.

I hereby certify that the facts set forth in this application are true and complete to the best of my knowledge. I understand that discovery of falsification of any statement or significant omission of fact during any phase of the hiring process may prevent me from being hired or if hired may subject me to immediate dismissal.
I, the undersigned, affirm the accuracy of all responses set forth in this application.*

YesNo
Date*

MonthDayYear
Date
Background Check Authorization:
The information contained in this application is correct to the best of my knowledge. I hereby authorize Applied Life Ministries, Inc. D/B/A Christian Ministries Academy and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me, to Applied Life Ministries, Inc. or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources.

Applied Life Ministries, Inc. and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, social security numbers, and dates of birth.
Social Security Number:*
Date of Birth:*

MonthDayYear
Date
Drivers License Number:*
Drivers License State of Issue:*
I, the undersigned, affirm the accuracy of all responses set forth in this application.*

YesNo
Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty:

Employment/Substitute Teacher/Volunteer Application & Background Check Authorization

Personal Information:

References

Professional Qualifications:

Teaching Experience

Personal Interests:

Christian Background:

Private Religious Organization Disclosure

Expectations for CMA Team Members

Statement of Doctrines

Applicant's Certification and Agreement:

Background Check Authorization: