Seacrest Country Day School
7100 Davis Boulevard
Naples, Florida 34104
239.793.1986
Fax: 239.793.1460
www.seacrest.org
APPLICATION FOR INSTRUCTIONAL POSITION
Name: / Date:
Last / First / Middle
Address:
Phone: / e-mail address:
Citizenship: / Social Security #:
POSITION
Position Desired: / Teacher / Administrator / Other:
Teaching Fields (in order of preference) / 1. / 2. / 3.
Level: / Preschool (PK-K) / Elementary (1-5) / Middle (6-8) / Secondary (9-12)
List school activities other than classroom teaching in which you are qualified to engage, e.g. Coaching, Dramatics,
Publications, etc.:
Date Available for Employment
Are you fluent in any foreign languages? / If so, list:
Notice of Nondiscriminatory Policy
Seacrest School admits students of any race, color, religion, disability, national or ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, religion, disability, age, sex, national or ethnic origin in administration of its educational policies, admissions and employment policies, scholarship and loan programs, and athletic and other school-administered programs.
EDUCATIONAL AND PROFESSIONAL TRAINING
Name of School or Institution and Address / Major / Minor / Degree / Mo./Yr.
High School
College University
To what educational organizations do you belong?
PRACTICE TEACHING EXPERIENCE
Name and Location of School / Directing Teacher / Grade / Subject Taught / Mo. / Yr.
If you are currently under contract, give name and location of school system:
Why do you wish to change your present position?
Have you ever been requested to resign from a position (or not been reappointed)? / Yes / No
TEACHING EXPERIENCE UNDER CONTRACT
Begin with most recent and list in chronological order. List additional on back.
Name and location of School City and State / Name of Principal / Salary Earned / Grade or Subject Taught / Reason for Leaving / No. of Years / From - To
Total years full time teaching experience under contract:
EDUCATIONAL REFERENCES
(Please list at least three)
Name / E-mail Address / Phone Number / Official Position
FLORIDA CERTIFICATE
Have you applied for a Florida Teaching Certificate? / Yes / No / If "Yes," when?
Date / Date
If you hold or have held a Florida Teaching Certificate, give: / Rank / Type / Issued / Expires
Number of Florida Certificate: / List Fields and Code Number on your Certificate:
EXPERIENCE OTHER THAN TEACHING
Type of Work / Dates / Location / Name of Employer
Have you ever been convicted of a misdemeanor (other than minor traffic violations), a felony, or any offense involving
moral turpitude? / Yes / No / If "Yes," please explain on a separate sheet.
Have you ever had a teaching certificate revoked in any state? / Yes / No
If so, where?
Have you ever received benefits from Workers' Compensation for any injury or loss of time? / Yes / No
Do you have a claim pending? / Yes / No / If "Yes," please explain on a separate sheet.
Give name, address, and phone number of person to be notified in case of emergency:
Please write a brief statement, in your handwriting, concerning your reason for wanting to work at Seacrest.
(Use back as needed.)
The above are true and accurate statements. I agree that any purposeful omission or false statements will constitute grounds for immediate dismissal. I also understand that unless this application is completed in detail, it will not be considered. All copies of transcripts and written references must be on file before an employment contract can be signed.
Signature of Applicant