Name:
Last: First: Middle: |
Present Address:
Street:
|
| City: State: Zip: |
Permanent Address:
Street:
City:State: Zip:
|
| Phone Number(s) or |
| |
|
EMPLOYMENT DESIRED/QUALIFICATIONS:
Please indicate, in
order of preference, the position(s) you desire and for which you
are qualified: |
| Position 1 |
| Position 2 |
| Position 3 |
Student Teaching:
Grade Level: Where: |
Kansas Certificate held:
Date Issued: Expiration Date: |
| |
|
List subject(s) / Grade(s) you are
certified to teach:
|
|
|
| |
|
| List student activities
you are qualified to sponsor: |
| |
|
|
|
|
| |
|
| EDUCATIONAL and
PROFESSIONAL TRAINING: |
| |
|
| Name & Location of Institution
|
Number of Years Attended:
Degree Received:
Date Received: |
| |
|
Name & Location of Institution
Number of Years Attended:
Degree Received:
Date Received: |
| |
|
Name & Location of Institution
Number of Years Attended:
Degree Received:
Date Received: |
|
| |
|
Name & Location of Institution
Number of Years Attended:
Degree Received:
Date Received: |
|
| |
|
Name & Location of Institution
Number of Years Attended:
Degree Received:
Date Received: |
|
| |
|
Undergraduate Major:# of Semester
Hours:
Undergraduate Minor:# of Semester Hours:
Graduate Work Emphasis:# of Semester Hours: |
| |
| RECORD OF
PROFESSIONAL EXPERIENCE: |
| |
| Name & Location of Institution:
|
| Grades or Subjects Taught: |
| Employed From/To: |
| Salary Received: |
| |
|
|
| |
|
|
REFERENCES: Please list the names, complete addresses and
phone numbers of at least three individuals who have knowledge of
your character and professional abilities, to serve as
references. |
|
|
| |
| General
Information: |
a. Please provide (in your own words)
a statement indicating the reason(s) you want to teach in our
schools. Include any background you have had in Effective
Schools research or workshops. Add any remarks you think will
strengthen your application .
|
| |
b. Have you ever been convicted of a
felony? Yes No
(This information will not necessarily bar employment.
Factors such as age, time of the offense, seriousness and
nature of the violations and rehabilitation will be taken into
account.) |
| |
c. In addition to
completing this application/resume, please have a set of your
credentials and official transcripts sent to the address below.
We also request a photocopy of your certificate (or a
photocopy of your application for certification).
Dennis Engels, Superintendent
Bluestem USD No. 205
711 North West Street
P. O. Box 8, Leon, Kansas 67074 |
| |
| d. The information
furnished on this application is true and accurate to the best of
my knowledge. Any misstatements or omissions of material
facts in this application may be cause for dismissal. I
understand that I may be required to take one or more
tests (Physical examination, drug screening, job related) as a
condition of hiring or continued employment. |
| |
| |
| Bluestem USD 205does not engage in
discriminatory practices in compliance with regulations
implementing Title VI, Title VII, Title IX, Age, Section 504 or
Title II of the Americans with Disabilities Act 1990. Notice
of nondiscrimination is available. |
| |
| |
| |
