Substitute Teacher New Hire Processing

Applications are being accepted. Please email application to:

You also have the option to drop off your application at the Board of Education Office or can mail it to the address listed on the form.

You will be contacted to set up a processing appointment.

Please note the requirements listed on the application.

Thank you,

Fay Mann

Human Resource Assistant


PENDLETON COUNTY SCHOOLS

2525 HWY 27 NORTH

FALMOUTH, KY 41040

859-654-6911

______

SUBSTITUTE TEACHER APPLICATION

Name ______Date ______

Address ______

City______State______Zip______

Phone# ______cell# ______

Social security # ______

E-mail address ______

Have you ever been employed with us? Yes____ no____

if yes, month & year______

location & position______

Schools in which you want to substitute: _____ all schools

_____ High School

_____ Middle

_____ Northern Elem.

_____ Southern Elem.

Days available to substitute: ______

Do you have a Kentucky Teaching Certificate? ___yes ____no

If yes, an original of your certificate must be attached.

______expiration

______degree

______certification area

Do you have a substitute certificate? _____ yes _____ no

If yes, an original of your certificate must be attached.

______expiration

Are you currently receiving Kentucky retirement benefits? ____yes _____no

Are you currently substituting at other School Districts? ______

In order to process your application, the following must be provided at the New Hire Processing appointment:

Ø  Teaching certificate

o  Valid Kentucky teaching certificate OR

o  Original college transcript (you must have 64 college credit hours with at least a 2.5 gpa) AND an emergency substitute certificate (process to obtain certificate will be started at the new hire processing appointment)

Ø  Verification proof

o  Passport OR

o  Social security card and drivers’ license

Ø  $36.50 for fingerprinting (cash payments must be the exact amount. Fingerprinting is done at our office.) For this type of employment, state law requires a national and state criminal history background check as a condition of employment.

Ø  Information will be given during the processing appointment for the required physical exam / TB assessment/drug screen (cost is employee’s responsibility) to be conducted by:

St Elizabeth Business Health Center

EQUAL OPPORTUNITY EMPLOYER

200 Medical Village Dr

Edgewood KY 41017

859-301-2999

Appointment needed

Office hours:

·  M-TH 7:30-6

·  Fri 8 – 5

·  Sat 7:30 – 12:30

EQUAL OPPORTUNITY EMPLOYER

Contact Fay () or call our office @ 859-654-6911 ext 2 if you have any questions.

------

EDUCATION:

Please indicate the high school and complete address from which you graduated: ______

Year graduated: ______

COLLEGES ATTENDED / ADDRESS, CITY, STATE, ZIP / DATES ATTENDED / DEGREE OR SEMESTER HOURS / MAJOR/MINOR

EXPERIENCE

LIST TEACHING EXPERIENCE IN CHRONOLOGIAL ORDER BEGINNING WITH THE LAST YEAR TAUGHT.

SCHOOL DISTRICT / ADDRESS, CITY,STATE, ZIP / SUBJECT / GRADE / DATE
EMPLOYED


LIST OTHER WORK EXPERIENCE STARTING WITH MOST RECENT.

NAME AND ADDRESS OF EMPLOYER / PHONE
NUMBER / POSITION / DATE
EMPLOYED

We may contact the employers listed above unless you indicate those you do wish us to contact.

Do not contact: ______

Have you ever been suspended, asked to resign or terminated from an employer? _____yes _____no

If yes, please explain: ______

______

Have you ever been convicted of violation of any law, regulation or ordiance? _____yes _____no

If yes, please explain: ______

______

REFERENCES

Name three individuals who can comment on your personal and professional qualifications.

NAME / ADDRESS, CITY, STATE, ZIP / PHONE # / RELATIONSHIP

Please carefully read the following, sign and date below.

I hereby affirm that the information given by me in this application is true and complete to the best of my knowledge and belief. I understand that any misrepresentation, falsification, or omission will be sufficient cause for cancellation of this application or discharge if I have been employed.

I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.

I understand that the District is required by state law to obtain criminal history record information on applicants as a condition of employment. I hereby give the District permission to make inquiries from any law enforcement agency.

It is agreed by and between the Pendleton County Schools and employee that an employee is an “at-will” employee and that the Superintendent may terminate the employment contract at any time.

Signature of Applicant ______

Date of Signature ______

The Pendleton County Schools does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in the employment of services. Any and/or all questions or issues related to discrimination policies, procedures or practices are to be directed to the Human Resources Office, Pendleton County Schools, 2525 Hwy 27 N., Falmouth, KY 41040 (859) 654-6911.

EQUAL OPPORTUNITY EMPLOYER