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 / PhoneEmployment 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 theMiddleEastBlack (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.