ParisIndependentBoardofEducation

310 West Seventh Street

Paris, KY40361

Phone(859)987-2160 Fax(859)987-6749

CertifiedPersonnel

EmploymentApplication

Date:

Name: SSN:

Address:

City: State: Zip:

PhoneNo.( ) E-Mail address

AreyouaU.S.Citizen?Y N (checkY-YesorN-No)

Haveyoubeenconvictedofafelonyormisdemeanor?Y N Date(s)______


(FORTHISTYPEOFEMPLOYMENT,STATELAWREQUIRESANATIONALANDSTATE CRIMINALHISTORYBACKGROUNDCHECKASACONDITIONOFEMPLOYMENT)

Interest

Whatpositionisofinteresttoyou?(1)

(2)

Totalnumberofyearsofrelatedexperiencereflectedinthisapplication:

If applying for a substitute teaching position and you do not have a teaching certificate, please list

the number of college credit hours on the Degree and Major line.

Education

College

Address

Graduation Date DegreeandMajor

College

Address


Graduation Date DegreeandMajor

TeachingCertificate(s)currentlyheld:

Listanyextracurricular(clubs,sports,organizations)activitiesyouwouldbewillingtosponsor:

ExperienceCertification

.Enteryourworkingexperienceinthefollowingpagesorprovideadetailed resumewithdatesof employment(month,year).IncludeU.S.Military,temporaryandunpaidemploymentthroughout

your careerintheorderinwhichtheyoccurred,beginningwithyourcurrentormostrecentemployment.

Teacher: EncloseyourKentuckyTeacherCertificationandCollegeTranscript.

EmployerName______StartEnd

Mo/Yr Mo/Yr

EmployerAddress

______City State Zip

JobTitleorDescription:


EmployerNameStartEnd

Mo/Yr Mo/Yr

______

EmployerAddress

City State Zip

JobTitle or Description:


EmployerNameStartEnd

Mo/Yr Mo/Yr

______

EmployerAddress

City State Zip

JobTitle or Description:

References

Name / Address / Title / Phone

Employment Questions

1. What qualities and characteristics do you believe make a teacher successful?

2. What are your main reasons for wanting a teaching position with Paris Independent Schools?

3. What are some strategies that you might use to develop strong parent and community involvement in

your classroom?

4. What personal skills or abilities do you possess that will make you a valuable employee in our school

district?

.Voluntary Self-Identification

· ParisIndependentBoardofEducationisanEqualOpportunityIAffirmativeActionemployer. Please

helpusmeasuretheeffectivenessofourrecruitmentactivitiesandmaintainstatisticalinformation regardingapplicantsforemployment.Youarenotrequired tofurnishthisinformation.

Male _____ Female _____

DateofBirth:Month Day Year

Pleasechecktheappropriatebox.

White(NotofHispanicorigin)AllpersonshavingoriginsinanyoftheoriginalpeoplesofEurope,NorthAfricaor theMiddleEast
Black (NotofHispanicorigin) AllpersonshavingoriginsinanyoftheBlackracialgroupsofAfrica.
AsianorPacific Islander-AllpersonshavingoriginsinanyoftheoriginalpeoplesoftheFarEast,SoutheastAsiaandIndianSubcontinent, orthePacificIslands. Thisincludes,forexample,China,Japan,Korea,thePhilippine IslandsandSamoa.
AmericanIndianorAlaska Native-AllpersonshavingoriginsinanyoftheoriginalpeoplesofNorthAmerica, andwhomaintainculturalidentificationthroughtribalaffiliationsorcommunityrecognition.
Hispanic-AllpersonsofMexican,PuertoRican,Cuban,CentralorSouthAmerican,orotherSpanishcultureor origin,regardlessofrace.
QualifiedApplicantwithaDisability-Anypersonwhom(1)hasaphysicalormentalimpairmentthat substantially limitsoneormoreofhisorhermajorlifeactivities,(2)hasarecordofsuchimpairment,or(3)is regardedashavingsuchimpairment. Adisabilityis"substantiallylimiting"ifit islikelytocausedifficultyin securing,retainingoradvancinginemployment
Eligible Veteran-Servedin U.S.MilitarybetweenAugust5,1964andMay7,1975.
Disabled Veteran-AnU.S.MilitaryVeteranwithadisability,serviceconnectedorotherwise.

Authorization

IauthorizeappropriateemployersandeducationalinstitutionstoprovidetheParisIndependentBoardof Educationinformation,whichmayberequiredforanemploymentdecision. Applicationinformationis herebycertifiedtobeaccuratetothebestofmyknowledge. Iunderstandthatmisrepresentationoruntrue informationmaybecauseforrefusaltohireorfordismissalifdiscoveredfollowingmyemploymentdate. IunderstandthatanofferofemploymentisnotbindinguponParisIndependentBoardofEducationuntil officiallyapprovedorcommunicatedinwritingbytheSuperintendentofParisIndependentSchools.

Signature: Date:

TheParisIndependentBoardofEducationselectsemployeesonthebasisof qualificationsforthe availablevacancyregardlessofapplicant'srace,color,nationalorigin,age,religion,genderor disability(CivilRightsActof1964). PleasecontactMr. Gary Wiseman,th St.Paris, KY40361or(859)987-2160if you havequestions/inquiries.