WilmarUnionSchool District

Certificated Job Application Form

(Note: This form may be handwritten in ink or typewritten.)

Name______Phone______e-mail______

Address______

City, State, Zip Code ______

Position for which you are applying: ______

Where did you hear about this job? Edjoin___, Craigslist____, Newspaper____, other:______

A complete application must include the following information:

  • A cover letter addressing your qualifications and reasons for interest in the position
  • Completion of this application form
  • A resume, including references (may be different than writers of recommendation)
  • Copy of your valid California credentials
  • A minimum of three letters of recommendation

Credentials now held

Type of credential______Expiration date______

Type of credential______Expiration date______

CLAD/BCLAD imbedded ______or separate credential/certification ______

For each question below answered “yes,” explain in writing the circumstances and attach to this application.

Have you ever been dismissed or asked to resign from any permanent position?Yes___ No___

Have you ever received a letter of non-reelection from any probationary position?Yes___ No___

Are you now the subject of any inquiry or disciplinary action with any alleged misconduct? Yes___ No___

Has your credential ever been suspended or revoked?Yes___ No___

Is any adverse action now pending against any credential you now hold?Yes___ No___

Have you ever been convicted of anything other than a minor traffic violation?Yes___ No___

Most Recent work history

School name and locationDatesContact/SupervisorPhone

______

______

______

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College/University education (copies of official transcripts are not required but appreciated)

School name and locationDates attendedDegreeMajor

______

______

______

I hereby certify that all foregoing statements are true and correct to the best of my knowledge. My signature below authorizes Wilmar Union School District to check my references and investigate all statements herein recorded. I release Wilmar Union School District from all liability for making such inquires as well as all persons and organizations reporting information regarding this application. I understand that any omission or false statement made by me on this application, or any supplement to it, or on any other employment document, is sufficient grounds to deny me employment or to discharge me should I become employed.

Signature______Date______

WilmarUnionSchool District is an Equal Opportunity Employer. The Board Policies prohibits discrimination in regards to race, color, religion, sex, age, marital status, national origin, ancestry, or physical handicap.

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