Professional Application


DIRECTIONS: PLEASE TYPE OR PRINT IN YOUR OWN HANDWRITING.

Social Security #: ______- ______- ______

Application Date: (MO) ____ / (DAY) ____ / (YR) ____


Date Available: (MO) ____ / (DAY) ____ / (YR) ____

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A / First Name:
Last Name:
Middle Name:
Street Address:
City, State, Zip:
County:
Day Phone:
Evening Phone:
Cell Phone/Pager:
Fax:
E-mail Address:
Primary Language: / English Spanish Other: ______
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A / Directions: Please check all that apply
Teacher: (SUB.)______
Coach
Administrator: (TYPE) ______
Counselor: (TYPE) ______
Other: ______/ GRADE LEVEL DESIRED:
Middle School (7-8)
Intermediate (9-10)
Senior High (11-12)
ELECTIVES YOU CAN TEACH:
Art
Music
Computer/Technology
Vocational Specialty / Drama/Theatre
Debate/Speech
Sport
Other: ______
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N / NAME OF SCHOOL / MAJOR/MINOR / DEGREE / YEAR GRADUATED
What was your grade point average in your major field of study during your Bachelor’s degree? ______Overall g.p.a? ______
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None
Texas Emergency
Valid Texas
Valid Other State: ______
Texas One-Year: Expires ______
Texas Temp. Administrative: Expires ______/ Please list your areas of certification:
  1. ______
  2. ______
  3. ______
  4. ______
  5. ______

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P. / Directions: Please list teaching experience beginning with the most recent years.
NAME AND LOCATION OF SCHOOL / TYPE OF ASSIGNMENT / DATES TAUGHT / NUMBER
YEARS / REASON FOR LEAVING
Totals years of creditable educational experience: ______
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E / Directions: Please provide a list of all other jobs or administrative positions you have held in the past 10 years. List
the most recent first. Attach additional sheets if necessary. Attach resume if available.
EMPLOYER AND LOCATION / POSITION/ TITLE / DATES EMPLOYED / REASON FOR LEAVING
Totals years of creditable educational experience: ______
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S / Directions: Please list references the district can contact regarding your work history. Please include all managers and supervisors who evaluated or supervised your performance at your last two places of work.
FULL NAME OF REFERENCE / RELATIONSHIP TO YOU / COMPLETE MAILING ADDRESS / POSITION/ TITLE / AREA CODE & PHONE #
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N / I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment.
It is understood that this application and all attachments included become the property of the PegasusSchool.
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 such parties from liability for any damage that may result from furnishing the same to you.
I understand that the school is authorized by Texas Education Code 22.083 to obtain criminal history record information on applicants the school intends to employ.
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Signature Date

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