Tallapoosa County Board of Education
Application For Employment (Certified)
679 East Columbus Street
Dadeville, Alabama 36853
256-825-0746
Please Read Carefully
All information will be treated confidentially. Please answer all questions as completely as possible. The use of this form does not indicate that there are positions open and does not obligate you or the Tallapoosa County Board of Education. The Tallapoosa County Board of Education does not discriminate in employment on the basis of race, sex, age, religion, ethnic group, handicapping condition, or national origin.
PERSONAL AND GENERAL INFORMATION:
Name (Last, First, Middle): Date
Present Address (Street, City, State, Zip):
Telephone Number:
Permanent Address (Street, City, State, Zip):
Telephone Number:
Social Security Number:
Race: (For record keeping purposes pursuant to Consent Decree, C.A. No. 849-E)
For What Position are you applying? Are you presently Employed?
Name and address of present employer:
Are you under Contract?
Why do you desire to change from present position?
EDUCATION PREPARATION:
School Attended Address Degree
Date of Graduation Major/Minor
School Attended Address Degree
Date of Graduation Major/Minor
School Attended Address Degree
Date of Graduation Major/Minor
School Attended Address Degree
Date of Graduation Major/Minor
Do you have the ability to perform the duties of the position for which you are applying ?
If yes, explain
Do you hold an Alabama Teacher Certificate? If yes, Type Rank Endorsements
If no, have you applied for a certificate? If yes, give date of application
List your intern/student teaching experiences
School Address Date Supervising Teacher
Grade Level/Subject Taught
School Address Date Supervising Teacher
Grade Level/Subject Taught
School Address Date Supervising Teacher
Grade Level/Subject Taught
School Address Date Supervising Teacher
Grade Level/Subject Taught
List any other special training, qualification, and experiences in any area of school or community work
TEACHING EXPERIENCE
List All TEACHING EXPERIENCE for which a teaching certificate was necessary, beginning with the most recent. Do not include substitute teaching, volunteer programs in schools, teacher’s aide, etc.
Give Dates From/To Name of School Location Name and Address of Board of Education Subject Taught for each experience
Total years and months of public school teaching experience
State Work experience other than education. Give addresses and dates of each experience
REFERENCES
Please list persons, not related to you, who have observed your work as a teacher, employee, or as a student. Include former superintendents, principals, supervisors, and instructors in your areas of preparation. Information must be current and complete.
Give Name/Address/Official Position/Phone (include in this the three to whom you are sending the objective reference form)
Tallapoosa County Board of Education
679 East Columbus Street
Dadeville, Alabama 36853
Certified Personnel Reference Form
Name of Applicant Major Position Applied For
Name of Reference Position/Firm Business Phone No.
I have applied for an instructional position with Tallapoosa County Board of Education. Since employment is partially dependent on my references, I would appreciate your completing the application sections of the reference form below. A self-addressed envelope is enclosed for your convenience.
[ ] I waive my rights to review this recommendation.
[ ] I do not waive my rights to review this recommendation.
______
Signature of Applicant Date
Comparing this applicant to others with whom you have worked, observed, or taught, where would you rank this applicant?
[ ] Top 3% [ ] Top 10% [ ] Top 25% [ ] Top 50% [ ] Below 50%
Comparing this applicant to others with whom you have worked, observed or taught, please check the following:
Superior
/ Above Average /Average
/ Below Average /Poor
/No Opportunity To Observe
Attendance and PunctualityPersonality
Understanding of Children and Learning
Planning and Organization
Competency in Subject
Use of Teaching Resources and Techniques
Evaluation of Pupil Growth and Learning
Support of Total School Program
Professional Attitude Toward School Work
Ability to Work with Pupils and Parents
Ability to Work with Other Teachers
Initiative and Enthusiasm
Classroom Management-Discipline/Control
Use and Care of School Facilities
Carrying Out School Policies
Reliability in Records and Reports
Dependability
Maturity
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1. This information covers the period from ______to ______.
2. What was your position during this time?______
3. Would you employ this person as a teacher?______
4. If this person were a former employee, would you employ again?______
5. On how many occasions have you formally/informally observed this person in classroom teaching situations?
Formal______Informal______
6. Should we call for additional information?______
7. Please use the back of this form for additional comments.
Signature______Date:______
(Print this page and respond to numbers 1 and 2 then sign it and mail or fax (256-82508244) it to Tallapoosa County Board of Education/Personnel Department)
RESPOND TO THE FOLLOWING IN YOUR OWN HANDWRITING, USE ADDITIONAL PAGES WHERE NECESSARY.
(Required for all certified positions)
1. Identify an instructional issue relative to your area of certification that is of concern to you and describe how you would attempt to solve it. (Give attention to grammar, punctuation, syntax, spelling, and neatness)
2. Briefly identify you reasons for wanting to be an educator and teach in the Tallapoosa County School System.
I authorize the Tallapoosa County Board of Education to obtain information concerning me from former employers and others, and I release all concerned from any liability in connection therewith. I also have full knowledge that any misrepresentation or omission of facts made by me on this application or any supplement will be grounds for immediate dismissal.
Date ______Signed ______