Minster Local Schools
A Tradition of Excellence
50 E. Seventh Street Minster, Ohio 45865 Phone: 419 / 628-3397 APPLICATION FOR PROFESSIONAL EMPLOYMENT The Minster Local School District is dedicated to the provision of equal Educational opportunities and equal employment opportunities without Regard to race, creed, economic status, national origin, sex or handicap.
Name _________________________________________________ Application Date __________________ (Last)
(First)
Present Address ________________________________________ Telephone _______________________ (Street and Number)
(Area Code)
_________________________________________________ (City)
(State)
(Zip)
Permanent Address ______________________________________ Telephone _______________________ (Street and Number)
(Area Code)
________________________________________________ (City)
(State)
(Zip)
Social Security Number __________________________________
U.S. Citizen? ____________________
Position(s) applied for: ( ) Elementary
(_________________)
(K-3)
Grade levels in order of preference
( ) Middle School
(_________________)
(4-8)
Grade levels in order of preference
( ) High School
(_________________)
(9-12)
Subjects in order of preference
( ) Special
(____________________) Area
( ) Guidance (____________________) ( ) Administration (________________) Position
Extracurricular Assignment Interest: Check any of the following activities which you are qualified and willing to coach or direct. Use a double check to show actual coaching or directing experience. ____ ____ _____ _____
Yearbook Dramatics Class Sponsor Student Council
Type of Ohio Teaching Certificate/License You Hold
_____ _____ _____ _____
Football Basketball Baseball Track
Date Issued
_____ Cross Country _____ Volleyball _____ Softball _____ Swimming
Date of Expiration
_____ _____ _____ _____
Certificate Number
Golf Cheerleading Clubs Other ______________________
Subjects or Grades Appearing on Certificate/License
Note: Please submit a copy of all valid Ohio certificates/licenses with this application.
FOR SCHOOL USE ONLY:
Date Received __________________
Date Interviewed __________________
School
Date Attended
Name & Location
Diploma or Degree
Total SEMESTER
Major
Minor
Hours
Grade Point Average
Distinctions or Honors
High School College or University
Total Number of SEMESTER Hours Earned:
_____
Undergraduate
Semester Hours in Your Teaching Field(s):
_____
Sem. Hrs. in ________________
Note: Copies of all transcripts should be submitted with this application. 3 quarter hours = 2 semester hours.
_____
Sem. Hrs. in _________________ GPA _____
Name & Location of School
_____
Name of Cooperating Teacher
Graduate
Grade
GPA _____
Subject
Date From
To
Note: Student teaching information may be omitted by teacher with three years or more experience.
Include all contracted positions you have held as a certified teacher. List chronologically with most recent position first. In Ohio, 120 or more days experience in the same school year equals one year. Name of School/Address (zip code)
Are you presently under contract?
Date From To
Position
(
) Yes
( ) No
Total Years
Reason for Leaving
If yes, to whom _______________________________________ School System
If yes, why do you wish to leave? ______________________________________________________________________ Have you been employed under a continuing contract in Ohio?
( ) Yes
( ) No
If yes, continuing contract was granted by ________________________________________ on ____________________ School System
Have you ever been discharged or requested to resign from a teaching position?
Date
( ) Yes
( ) No
If yes, explain ______________________________________________________________________________________ _________________________________________________________________________________________________________ Have you previously applied for a position in the Minster Local School District?
( ) Yes
( ) No
Firm
Location
Kind of Work Performed
Dates of Service
List experiences you have had working with children (outside of school). Home __________________________________________________________________________________________________ Community _____________________________________________________________________________________________ Camp __________________________________________________________________________________________________ Other __________________________________________________________________________________________________
Have you served in the military? __________ If so, list active service dates __________________________________________ Service Branch ________________________ Honorably Discharged? ____________ Rank at Discharge _________________ Significant duties/honors: __________________________________________________________________________________ The District is prohibited from inquiring about prior criminal convictions of any applicant on an application form. However, certain employees of the District must undergo a criminal background check as a condition of employment. An employee who has been convicted of or plead guilty to one or more of the disqualifying offenses enumerated in the Ohio Revised Code may be deemed ineligible to work in the District. Please list at least THREE professional references. Experienced teachers MUST include the names of principals and/or superintendents under whom they have worked, including the most recent supervisor or administrator. Beginning teachers MUST include the name of the cooperating teacher. NOTE: If you have a current placement file, please request that it be sent to us. A. Professional References: 1.
_______________________________________________, ___________________________________________________, Name
Position or Occupation
___________________________________________________________________________, ________________________ Address
Phone Number
2. _______________________________________________, ___________________________________________________, Name
Position or Occupation
___________________________________________________________________________, ________________________ Address
Phone Number
3. _______________________________________________, ___________________________________________________, Name
Position or Occupation
___________________________________________________________________________, ________________________ Address
Phone Number
B. Personal References: ___________________________, _______________________________________________, _______________________ Name
Address
Phone Number
____________________________, _______________________________________________, _______________________ Name
Address
Do we have your permission to contact the above mentioned persons? ( ) Yes Have you requested that your placement file be sent to us? ( ) Yes ( ) No
Phone Number
( ) No
Briefly describe any professional recognition, memberships, and growth activities: _____________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ In the space below, please include any other pertinent data or information, not previously requested on the application, which might assist us in arriving at a more realistic appraisal of your training, experience, and overall competence for the position for which you are applying ____________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________
Please use the space below to express, in your own handwriting, a portion of your educational philosophy. ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ I hereby authorize the Minster Local Schools to obtain from my previous employer(s) all data necessary to support this application. I certify that all information on this application is true and complete to the best of my knowledge. I understand that any withholding or falsification of information on this application constitutes grounds for dismissal if I am employed. As an applicant with Minster Local Schools, I make the following commitments that I will abide by if employed: 1.
I will respect other human beings regardless of race, sex, color, creed, handicap, or economic status.
2.
As an educator, my highest priority will be service to students.
3.
I will spend the time necessary to plan and organize for successful teaching.
4.
I will spend time to attend and help supervise school activities and professional meetings outside of school hours.
5.
I will assume additional duties to assure an efficient school operation such as hall duty, playground duty, etc.
6.
I will continuously strive for better ways to help youngsters grow and learn through professional reading, further training, and participation in staff development activities.
7.
I will take pride in my personal appearance and conduct to help ensure a proper image for students. _____________________________________________________________ Applicant’s Signature
_________________________________ Date
In consideration of the disclosure and receipt of personal information necessary for full consideration of this employment application, I authorize the release of all high school, college, or other education records pertaining to my attendance, course work, and other school activities. I further consent to the disclosure of any and all information contained in private and governmental files relating to this employment application or relating to my present and former employment history. I authorize and request all former employers and federal, state, and local government agencies to release such information to Minster Local School District or its agent upon request. Minster Local School is also authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies of their choice. I release Minster Local Schools, its employees and agents, and all sources of information listed above from any and all legal liability arising from the release of the foregoing information to Minster Local Schools, or any other party with a proper and appropriate interest. _________________________________________________________________ Signature of Applicant
_________________________________________________________________ Maiden Name
FOR SCHOOL USE ONLY:
__________________________________ Date
__________________________________ Date of Birth
Receipt Acknowledged By: __________________________________________
