FIRST NAME MIDDLE LAST / DATE
STREET / HAVE YOU PREVIOUSLY BEEN EMPLOYED BY JCS?
YES NO
CITY / IF YES MONTH YEAR
FROM:______
STATE / ZIP CODE / TO:______
TELEPHONE NUMBER / SOCIAL SECURITY NUMBER
EMERGENCY CONTACTADDRESS TELEPHONE NUMBER
WILL VISA OR IMMIGRATION STATUS YESCOMMENT
PREVENT LAWFUL EMPLOYMENT?NO
PHONE / LIST RELATIVES AT JCS

EDUCATIONAL RECORD

NAME OF COLLEGE(S) / LOCATION / DATE(S) ATTENDED / DEGREE(S) / TEACHING MAJOR(S) / TEACHING MINOR(S) / QTR
UNITS

STUDENT TEACHING EXPERIENCE

CITY ______SCHOOL ______GRADE ______SUBJECT ______DATE ______

NUMBER OF YEARS OF CERTIFIED TEACHING EXPERIENCE PUBLIC ______PRIVATE ______

TEACHING EXPERIENCE (MOST RECENT FIRST; INDICATE F=FULL TIME; P=PART TIME; S=SUBSTITUTE)

SCHOOL NAME/
LOCATION / GRADES AND/OR SECONDARY
SUBJECTS TAUGHT / F
P
S / DATES
FROM TO / COACHING / ACTIVITY
ASSIGNMENTS

PROFESSIONAL INFORMATION (LIST BELOW - TEACHING, ADMINISTRATIVE, AND SPECIAL CERTIFICATES HELD)

TYPE OF CERTIFICATE / DATE ISSUED / DATE EXPIRES / STATE

REFERENCES: (PROFESSIONAL)

NAME / POSITION / ADDRESS / PHONE

REFERENCES: (PERSONAL, PASTOR or ELDER)

POSITION SOUGHTIn the boxes designate in order of preference the type of position sought. A “1” indicates position most desired. On the line indicate specific subject or grade preference.

Pre-Kindergarten/Kindergarten / Other ______/ Librarian ______
Lower Elementary ______/ Special Education ______/ Counselor ______
Upper Elementary ______/ Preschool ______
Specialist (area) ______/ Administration ______/ Full time
Middle School (subjects) ______/ Part time

LIST ENDORSEMENTS QUALIFIED TO TEACH (Mark “E” for Elementary, “MS” for grades 6-8)

______/ ______/ ______
______/ ______/ ______

LIST SPORTS YOU ARE QUALIFIED TO COACH

______/ ______/ ______
______/ ______/ ______

LIST SCHOOL ACTIVITIES YOU COULD DIRECT

______/ ______/ ______
______/ ______/ ______

ON A SEPARATE SHEET, PLEASE COMMENT ON THE FOLLOWING:

Please explain why you wish to teach at Jenison Christian school.

Clearly state your philosophy of Christian education.

Describe your view of how you would be a promoter of the school.

List skills and interests that you possess which help qualify you as an educator.

Describe what environmental factors and resources make you most successful as an educator.

Explain your view of technology and its role in your classroom .

Describe your classroom management style and your view of discipline.

PERSONAL DATA

Referral Source:FriendRelativeCSI websiteOther ______
Have you ever been convicted of crimes involving violence, dishonesty, breach of trust, child abuse, substance abuse or moral turpitude?
YesNo
If yes, indicate the nature of the offense, date, court, and disposition: ______

PHYSICAL DATA

Do you have any sensory, mental or physical handicaps, which would prevent you from performing the job for which you are applying?
YesNo
If yes, explain: ______

PLEASE SUBMIT THIS APPLICATION, RESUME, PLACEMENT FILE (for applicants with less than 5 years of experience), COPIES OF TRANSCRIPTS, THREE WRITTEN REFERENCES AND A COPY OF ANY PROFESSIONAL TEACHING CERTIFICATE (must qualify for Michigan initial certificate) TO THE JENISON CHRISTIAN OFFICE, 7726 GRACELAND DR, JENISON, MI 49428

APPLICANT IS RESPONSIBLE FOR PROVIDING PLACEMENT FILES, COPIES OF TEACHING CERTIFICATES, AND TRANSCRIPTS.

We hire only United States citizens and aliens lawfully authorized to work in the United States. If hired, you will be required to complete an Employment Eligibility Verification supplied by the Immigration and Naturalization service and will be asked to provide a document(s) to verify your citizenship or legal authorization to work in the United States.

As a religious educational institution, JenisonChristianSchool is permitted and reserves the right to prefer employees on the basis of religion. Title VII, Section 702-703, U.S. Civil Rights Act of 1964, as amended: Rev. Code of Washington 49.60.040.

PURPOSE OF JENISONCHRISTIANSCHOOL

Jenison Christian School is a well established, society owned preschool through eighth grade educational institution committed to providing its students Christ centered education through a biblically based and standards (State of Michigan) curricula.

BELIEF STATEMENT

We believe the scriptures of the Old and New Testaments to the Word of God, the only infallible rule of faith and practice, and that this divine Word of God has been most clearly and consistently interpreted in the Reformed creeds, namely the Heidelberg Catechism, the Cannons of Dordt, and the Belgic Confession.

Do you Agree with the JCS Belief Statement?YesNo
Have you accepted Jesus Christ as your Lord and Savior? ______
Church Home ______Pastor’s Name ______
Address ______Phone ______

AGREEMENT

I hereby authorize Jenison Christian School (JCS) to inquire as to my performance and/or record of any or all of my former employers and my church. Furthermore, I authorize JCS to request a criminal history check with local or state police, or FBI. I understand that any false statements made on this application will be sufficient cause for discharge.
______
Signature

JENISON CHRISTIAN SCHOOL IS AN EQUAL OPPORTUNITY EMPLOYER AND IS SEEKING ENTHUSIASTIC DISCIPLES OF JESUS CHRIST WHO WILL JOIN US IN CREATING A LEARNING ENVIRONMENT WHERE EVERY PERSON FEELS SAFE AND IS REGARDED WITH RESPECT AND DIGNITY.