SMITH MOUNTAIN LAKE CHRISTIAN ACADEMY
Application for Teacher
We believe that the most important component for the success of our school is a dedicated and excellent faculty with a testimony beyond reproach.
Date: ______Position:______
A) PERSONAL INFORMATION
Date of Birth:______
Name: ______SSN:______
Address:______
______Length at this address:______
Previous Address:______
______Length at this address:______
Phone:______Cell:______Email:______
Church Affliliation:______Member_____yes______no
Marital Status: Married_____Single______NeverMarried______Engaged______
Divorced_____Separated______Re-Married______Widowed______
Spouse’s Name______Years Married:______
Military Status:______
B) EDUCATION:SchoolDegreeDatesGPA
High School______
College______
College Transcripts will be required.
List other academic pursuits (Training Programs, conferences, seminars):______
______
______
List all Certifications/Licenses (areas, levels):______
______
______
List any honors or awards from college to present:______
______
C) TEACHING EXPERIENCE:
______
DatesSchool NameSchool Address
______
Subject(s)Grade Level#Students
______
SupervisorSupervisor Phone/Email
______
Reason Left
______
DatesSchool NameSchool Address
______
Subject(s)Grade Level#Students
______
SupervisorSupervisor Phone/Email
______
Reason Left
______
DatesSchool NameSchool Address
______
Subject(s)Grade Level#Students
______
SupervisorSupervisor Phone/Email
______
Reason Left
D) WORK EXPERIENCE:
______
DatesName of EstablishmentTitleSupervisor
______
Reason Left
______
DatesName of EstablishmentTitleSupervisor
______
Reason Left
______
DatesName of EstablishmentTitleSupervisor
E) CHRISTIAN AND EDUCATIONAL PHILOSOPHY:
On a separate sheet, please answer or discuss the following in one-two paragraphs:
- Briefly describe your salvation experience.
- What is your description of a biblical worldview?
- Describe events or circumstances that confirm God’s calling for you to be a teacher.
- What intentional steps do you take to grow in Christ?
- Comment on Jesus’ statement that it would be better to have a millstone tied around your neck and thrown into a lake than to lead a little one astray.
- Why do you want to teach at SMLCA?
- Share one moment in your teaching experience where all of your training, experience and hard work paid off.
- List all extra-curricular activities (arts, athletics) with which you have experience
F) REFERENCE:
Current Pastor:
Name:______Phone:______
Address:______
Relationship:______E-Mail:______
Non-pastoral Spiritual Reference (someone who knows you well):
Name:______Phone:______
Address:______
Relationship:______E-Mail:______
Education Supervisor (most recent):
Name:______Phone:______
Address:______
Relationship:______E-Mail:______
One more of your choices:
Name:______Phone:______
Address:______
Relationship:______E-Mail:______
G) LEGAL QUALIFICATIONS:
(If you answer “yes” to any of the below questions in this section, please attach a separate sheet indicating the nature of the suit, offense, date, court, and disposition or other appropriate explanations.)
Are you presently being investigated or under a procedure to consider your discharge for misconduct by your present employer or, if you offered a resignation, your previous employer?
Yes_____No______
Have you ever been discharged or asked to resign from a prior position?
Yes_____No______
Have you ever been denied a license?
Yes____No______
Have you ever been convicted (in civil or criminal proceedings) of any offense involving improprieties regarding children?
Yes_____No______
Have you ever been convicted of any crime other than the above (omit minor traffic offenses)?
Yes_____No______
Have you ever entered a court plea of guilty, or “no contest” (nolo contendere), or has any court ever deferred further proceeding without entering a finding of guilty, and placed you on probation or in a public service or education program for any crime other than a minor traffic offense?
Yes_____No______
Non-Discrimination Statement and Policy
Smith Mountain Lake Christian Academy is an equal opportunity employer. We will not discriminate and will take measures to ensure against discrimination in employment, recruitment, advertisements for employment, compensation, termination, upgrading, promotions, and other conditions of employment against any employee or job applicant on the basis of race, color, gender, national origin, age, creed, disability, or veteran’s status.
Agreement of Principals and Release of Information
____I agree with and will abide by all the principles set forth in the preceding documents, without reservation. (This is not necessarily a prerequisite for employment. Please fill in below.)
_____I agree with and will abide by all the principles set forth in the preceding documents with the exception of ______because______
I grant permission for SMLCA to contact all employers and references listed. I also understand a criminal background check, including a FBI fingerprint review, is required for employment. I understand that if any information provided in this application proves to be false or intentionally misleading, it could disqualify my standing as a prospective applicant and could result in terminating my employment without future remuneration. I waive any right to personally review any reference information provided on my behalf.
I understand that SMLCA does not discriminate in its employment practices against any person because of race, color, national or ethnic origin, gender, age or disability.
______Date:______
Signature
______
Printed
Mail this completed form to:Smith Mountain Lake Christian Academy
2485B Lost Mountain Road
Wirtz, VA 24184
Or you may email to:
SMLCA Personal Information
Employee Full Name:______
Date of Birth:______
Preferred Name:______
Home Address:______
Phone Number:______Email:______
Church Affiliation:______Member: Yes___No___
Pastor Name:______Phone Number:______
Spouse Name:______
Home Address (if other than above):______
Daytime Phone:______Cell:______
Employer:______Email:______
Emergency Information:
IN CASE OF ACCIDENT OR SERIOUS ILLNESS, YOU HAVE PERMISSION TO CONTACT THE FOLLOWING:
Emergency Contact:______Relationship:______
Address:______
Phone:______Cell:______
Family Doctor:______Phone:______
Hospital:______Phone:______
Employee Signature______Date:______
2485 B Lost Mountain Rd. Wirtz, Va 24184 540-719-1192