MAYSVILLE LOCAL SCHOOL DISTRICT
3715 Panther Dr., Zanesville, OH 43701
PHONE 740-453-0754
FAX 740-455-4081
APPLICATION FOR AN ADMINISTRATIVE POSITION
Name ______Social Security No. ______
Last First Middle/Maiden
Present Address ______Home Phone ______
Street
______Business Phone ______
City State Zip
ADMINISTRATIVE POSITION PREFERRED:
_____ Principal _____ Assistant Principal _____ Central Office
1st Choice ______2nd Choice ______
3rd Choice ______
List other administrative areas you are qualified to direct: ______
______
I will be available for employment: ______
Date
Note: Please submit a copy of all of your Ohio administrative certificates with this application.
Name of Ohio Administrative Certificate Date Issued Date of Expiration Certificate Number
______
______
______
pplication.
If you do NOT hold a valid Ohio certificate –
Have you applied for one? Yes No Date applied ______
Are you eligible for other certificates not presently held? Yes No
List: ______
Do you hold certificates from other states? Yes No
List: ______
My PROFESSIONAL TRAINING is as follows:
School Name & Location Date Attended Degree Total Semester Hrs. Major GPA
______
______
______
______
How many college or university hours have you earned in your administrative area(s)
during the last three years? ______
NOTE: THE APPLICANT SHOULD SUBMIT AN OFFICIAL TRANSCRIPT OF ALL
COLLEGE TRAINING WITH THIS APPLICATION OR AS SOON AS AVAILABLE.
Include all contracted positions you have held as a certified teacher or administrator. List chronologically with the
most recent positions first. In Ohio, 120 or more days experience in the same school year equals one year.
Name of School Principal’s Name/ Grades, Subjects, Dates Total
Address/Zip Phone Number Assignments From To Years
______
______
______
______
You have my permission to contact any of the above mentioned persons. Yes No
Are you presently under contract? Yes No If yes, to whom ______
Have you been employed under a continuing contract in Ohio? Yes No
My continuing contract was granted by ______on ______
School System Date
Have you ever been discharged or requested to resign from a teaching position? Yes No
If yes, explain ______
______
Have you previously applied for a position at Maysville Local School District? Yes No
If yes, explain ______
______
Are you eligible for United States military service credit? Yes No
Dates served? From ______To ______
Other work experiences which I believe have been valuable to my career are: ______
______
______
______
______
Have you ever been convicted of a felony? Yes No
If so, explain ______
______
I hereby authorize the Maysville Local School District to obtain from my former employer all data needed
to support this application. I certify that all information on this application is true and complete to the best
of my knowledge. I understand that any withholding of falsification of information on this application is
grounds for dismissal.
______
Applicant’s Signature Date
It is the policy of the Maysville Board of Education that the best qualified applicant
shall be selected for each position without regard to race, color, religion, national
origin, age, sex, ancestry, disability, military status, genetic information, or any other legally protected characteristic, in its programs and activities including employment opportunities.
Revised 5/2013