Licensed Application

De Queen Public Schools

101 North 9th Street

De Queen, AR 71832

The De Queen School District is an equal opportunity educational and employment institution. The law protects the rights of an equal employment opportunity regardless of race, religious creed, national origin, ancestry, physical handicap, sex, or age.

We are delighted that you are interested in being considered for a position in the De Queen School District.

The following process and guidelines will be followed relative to this application:

  1. Your application will be reviewed and placed in our active files for consideration. Applications should be complete and include all the information requested.
  1. A limited number of applicants will be interviewed. Some applicants may not be interviewed.
  1. Interviews will be arranged by administrators from the building(s) and the central office staff.
  1. Applicants may contact the central office to determine the status of the application and/or availability of positions.
  1. Selected applicants will be recommended to the superintendent and school board. Recommendations do not imply automatic employment.
  1. If you are not interviewed, recommended, or selected for employment, your application will remain in the school system’s active file for one year.
  1. After you submit your application, it is not necessary for you to contact the central office unless you want to notify us of a change in name, address, phone number, or credentials, or to request withdrawal or renewal of your application.
  1. If you wish to apply for a different vacancy, notify the central office by phone or in writing.
  1. It is the responsibility of the applicant to see that all written references are filed with the application.
  1. The application and its supplements become the property of the De Queen School District upon submission, and the applicant releases all rights to retrieve it or any portion of its contents.

/ DE QUEEN PUBLIC SCHOOLS
101 North 9th Street
De Queen, AR 71832
870-584-4312

LicensedEmployment Application

Applicant Information

Full Name: /
Date:

Last

/

First

/

M.I.

Address:

Street Address

/

Apartment/Unit #

City

/

State

/

ZIP Code

Phone: /
Email
Date Available: /
Social Security No.:
/
Desired Salary:
/ $
Position Desired: / First Choice

Second Choice______

Third Choice______

To what professional organizations do you belong? ______

Are you currently under contract with another district? ______If yes, when does it expire? ______

Are you a citizen of the United States? / YES / NO /
If no, are you authorized to work in the U.S.?
/ YES / NO

Green Card Number (if applicable) ______

Have you ever worked for this district? / YES / NO /
If yes, when?
Have you ever been convicted of a felony or a misdemeanor? / YES / NO / If yes, explain:______
Have you ever had an ethics allegation or finding? If so, explain. / YES / NO / ______
As a teacher, have you ever failed to have a contract renewed or been placed on probation? If so, explain. / YES / NO
______
In case of an emergency notify: / Name: ______
Address: ______
Phone #: ______

Student Internship (if within last five years)

Date ______District______
Spring/Fall______College Supervisor______
Subject or Grade Level ______
Names and Addresses of supervising principal and cooperating teachers for internship:

Education

High School: /
Address:
From: /
To:
/
Did you graduate?
/ YES / NO /
Diploma::
College: /
Address:
From: /
To:
/
Did you graduate?
/ YES / NO /
Degree:
College:: /
Address:
From: /

To:

/

Did you graduate?

/ YES / NO /

Degree:

References

Please list three professional references.

Full Name: /

Relationship:

Position: /

Phone:

Address:
Email address:
Full Name: /

Relationship:

Position: /

Phone:

Address:
Email address:
Full Name: /

Relationship:

Position: /

Phone:

Address:
Email address:

Previous Experience

District: /

Phone:

Address: /

Supervisor:

Job Title: /

Starting Salary:

/ $ /

Ending Salary:

/ $
Responsibilities:
From: /

To:

/

Reason for Leaving:

May we contact your previous supervisor for a reference? / YES / NO
District: /

Phone:

Address: /

Supervisor:

Job Title: /

Starting Salary:

/ $ /

Ending Salary:

/ $
Responsibilities:
From: /

To:

/

Reason for Leaving:

May we contact your previous supervisor for a reference? / YES / NO
District: /

Phone:

Address: /

Supervisor:

Job Title: /

Starting Salary:

/ $ /

Ending Salary:

/ $
Responsibilities:
From: /

To:

/

Reason for Leaving:

May we contact your previous supervisor for a reference? / YES / NO
TOTAL NUMBER OF YEARS EXPERIENCE

Military Service

Branch: /

From:

/

To:

Rank at Discharge: /

Type of Discharge:

If other than honorable, explain:
Applicant’s Statement
Explain why you chose to enter the field of education and describe your career goals in the profession.

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature: /

Date:

Please include the following materials with your application:

Current teaching license/certificate

Transcripts from colleges

PRAXIS results (or other assessments relative to the position)

Resume` if desired

List of references

Please return to:

De Queen Public Schools, 101 N 9th Street, De Queen AR 71832

Documents may be scanned or downloaded to email to

FOR DISTRICT USE ONLY

Date Interviewed ______

Interviewed by ______

License ______

Official transcripts ______

References ______

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