Position

Name

DEL NORTE SCHOOLS C-7

770-11th Street

DEL NORTE, CO 81132

(719) 657-4040

TEACHER

Del Norte School District C-7 is an equal opportunity educational institution and does not unlawfully discriminate on the basis of race, color, national origin, sex, or disability in admission or access to, or treatment or employment in, its educational program or activities. Inquiries concerning Title Vi, Title IX Section 504 and ADA may be referred to: Superintendent of Schools, Del Norte School District C7, 770-11th Street, Del Norte, CO 81132. (719) 657-4040, or to the Office of Civil Rights, US Department of Education Region VIII, Federal Office Building, 1244 North Speer Blvd., Suite 310, Denver, CO 80204 (303) 844-2991.

Name: Social Security #:

Address: Telephone # (Home)

Telephone # (Work)

Position Sought:

Primary Certification:

24 Semester hours in which subject areas:

Areas of Endorsement:

Other Certification Held: ______

(An applicant must be able to qualify for a Colorado Teaching License. For information regarding licensing, contact the Colorado Dept. of Education, 201 East Colfax Ave., Denver, CO 80203 Phone: 303-866-0793.)

Have you been employed in this district previously?

If yes, when? ______

Are you related to any current employee of the district?

If yes, who?

Do you have any physical handicaps or problems which would prevent you from safely performing the tasks demanded by the position for which you are applying?

If yes, please explain.

Have you ever been convicted of any felony or misdemeanor other than a misdemeanor traffic offense or infraction?

Check those extra curricular activities you can direct.

[ ] School Newspaper[ ]Yearbook[ ]Debate

[ ]Drama[ ]Class sponsor[ ]Cheerleader

[ ]Football[ ]Basketball[ ]Volleyball

[ ]Track[ ]Baseball[ ]Speech

[ ]Knowledge Bowl[ ]Pep Band[ ]Other: Exercise Sci.

[ ]Soccer[ ]Student Council[ ]Wrestling

EDUCATIONAL INFORMATION

Colleges AttendedDatesHoursDegree

STUDENT TEACHING

Complete if you have less than five years experience.

District/LocationDatesSubject/Level Supervisor

PREVIOUS EXPERIENCE

Please list the most recent employer first.

District/LocationDatesSubject/Level Supervisor

______

______

Total years of experience: ______

PROFESSIONAL ACTIVITIES AND INTERESTS

Please list workshops, awards, publications, organizations, travel, honors, etc.

REFERENCES

Please list up to five individuals, three who know of your teaching skills.

PERSONAL STATEMENT

Discuss your educational philosophy, professional goals, development of your interests in teaching, personal interests in a position here, or make any other statements which you feel will enhance your prospects of obtaining a position in this district.

Please have your placement credentials sent to us as soon as possible.

To the best of my knowledge, the above information is accurate and correct.

Signature of Applicant Date