Nashville Public Schools

NASHVILLE PUBLIC SCHOOLS

Nashville, Arkansas

Administration Phone (870) 845-3425

Fax (870) 845-7344

PROFESSIONAL APPLICATION

The NashvilleSchool District does not discriminate in employment on the basis of race, color, sex, national origin, or handicap.

Name: Last / First / Middle / Maiden
Present Address
City / State / Zip Code / Phone
Permanent Address
City / State / Zip Code / Phone
Social Security Number
U.S. Citizen / Yes / No / Green Card Number

IN CASE OF AN EMERGENCY NOTIFY

Name / Address

POSITION DESIRED

Please indicate the grade level, subject matter or type of administrative position you prefer.

First Choice
Second Choice
Third Choice
Please Return to:
Nashville Public Schools
600 N 4th Street
Nashville, AR71852 / FOR DISTRICT USE ONLY
Date Interviewed
Interviewed By
Certificate
Official Transcripts
Reference

Educational and Professional Training

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

Student Intern (if within the last five years)

Year / Fall / Spring / School District
Subjects or Grade Level / Name and Address of Supervising Principals and Cooperating Teachers / College Professor Who Supervised Student Teaching

Teaching Experience

Name Of School / Location / Grade or Subject Taught / Date / No. of Years / No. Of Teachers in System
Total Number of Years

Professional Certification

State of Issuance / Teaching Area / Date Valid Issued Expires / Type of License / Grade Level

References

List names of professional references that would have first-hand knowledge of your character, personality, and teaching ability. List at least one administrator for each of your teaching positions. Submit three (3) letters of recommendation in addition to those listed.

Please include complete address information.

Full Name Of Reference / Mailing Address / Phone / Position

General Information

To what professional organizations do you belong?
Are you currently under contract with another district? / Yes / No
If yes, when does your contract expire?
Have you ever been convicted of a felony or misdemeanor? / Yes / No
If yes, please explain
As a teacher, have you ever failed to have a contract renewed or been placed on probation? / Yes / No
If yes, please explain

Veteran Information(please indicate if any of the following apply to you)

Veteran under age fifty-five (55)?_____Yes____No

Veteran who is over the age of fifty-five (55), disabled (it is not necessary that the disability is service-connected), and entitled to a pension or compensation under existing laws? _____Yes ____No

Veteran that suffers from a service-connected disability?_____Yes____No

Spouse of a deceased veteran who is unmarried at the time of hiring?_____Yes____No

Spouse of a veteran who suffers from a service-connected disability?_____Yes____No

Applicant’s statement

Original Statement Please respond to the following in your own handwriting. Explain why you chose to enter the teaching profession and describe your career goals in the profession.

District's Statement

Include the following:

A copy of teaching certificate/license OR

Letter from Arkansas college stating all requirements completed for verification of initial licensure (New teachers) OR

Verification of provisional licensure eligibility OR

Non-traditional licensure verification

Three letters of reference

Copy of your college transcript for all college credit

Praxis I and II test results

Resume' if desired

READ CAREFULLY BEFORE SIGNING

Application forms are sent to all who request them regardless of existing vacancies. The issuance of such forms does not signify that the applicant is under consideration for appointment.

An application remains active for a period of (2) years and must be renewed following this period.

The facts set forth in my application for employment shall be considered true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice.

Signed:
Date: