Rosslyn Academy
Application for Employment - Teacher
APPLICANT INFORMATION
Position(s) Applied for: / You may apply for more than one position! /
Full Name: / FirstName / LastName / I / Date: / Date
First / Last / M.I.
Address: / Strt / Apartment
Street Address / Apartment/Unit#
City / State / ZIP Code /
City / State / ZIP Code
Home Phone: / Home phone / Fax or Email Address A: / email /
Work Phone: / Work phone / Fax or Email Address B: / email
Date Available: / Date / Citizenship: / Citizenship / Birth Date: / DOB / Age: / Age
Health status? / Excellent
☒ / Good
☐ / Average
☐ / Poor
☐ / Physical Disabilities? / Enter any disabilities here
Marital status? / Single
☐ / Engaged
☐ / Married
☐ / Widowed
☐ / Separated
☐ / Divorced
☐ / Remarried

SPOUSE
Please complete if applicable.
Spouse’s Name: / LastName / FisrtName / I / Age: / Age
Last / First / M.I.
Spouse’s Vocation: / Vocation / Years Married: / years /
DEPENDANTS
Please complete if applicable
Dependant’s Name: / FirstName / I / Birth Date: / D.O.B /
First / M.I.
Age: / Age / Grade Level: / Grade
Dependant’s Name: / FirstName / I / Birth Date: / D.O.B
First / M.I.
Age: / Age / Grade Level: / Grade
Dependant’s Name: / FirstName / I / Birth Date: / D.O.B
First / M.I.
Age: / Age / Grade Level: / Grade
Please describe any particular educational or medical needs that your chid(ren) and/or spouse have, and any additional information about your family that would be helpful.
Tell us about your family
EDUCATION
College/Unv: / College/University / Location: / Location
Dates: / From / To: / To / Did you graduate? / YES
☐ / NO
☐ / Degree: / Degree
College/Unv: / College/University / Location: / Location
Dates: / From / To: / To / Did you graduate? / YES
☐ / NO
☐ / Degree: / Degree
College/Unv: / College/University / Location: / Location
Dates: / From / To: / To / Did you graduate? / YES
☐ / NO
☐ / Degree: / Degree
*Please attach an electronic copy of transcripts from the schools you have attended and submit with the application
TEACHERS
Do you possess a valid teaching/professional certificate? / YES
☐ / NO
☐ / Grade Level: / Grade(s) /
Area(s) of certification: / Certification(s) /
Certification State: / State / Expiry Date: / Date /
*You may later be asked to submit an electronic copy of your teaching certificate.
TEACHING EXPERIENCE
Please list your past 3 positions or past 15 years of employment, whichever is greater, starting with the most recent.
School: / School / Address: / Address
Dates: / From / To: / To / Position/Grade: / Position/grade / Phone: / Phone /
School: / School / Address: / Address
Dates: / From / To: / To / Position/Grade: / Position/grade / Phone: / Phone /
School: / School / Address: / Address
Dates: / From / To: / To / Position/Grade: / Position/grade / Phone: / Phone /
School: / School / Address: / Address
Dates: / From / To: / To / Position/Grade: / Position/grade / Phone: / Phone /
School: / School / Address: / Address
Dates: / From / To: / To / Position/Grade: / Position/grade / Phone: / Phone /
School: / School / Address: / Address
Dates: / From / To: / To / Position/Grade: / Position/grade / Phone: / Phone /
REFERENCES
Please list three character references and three professional references.
CHARACTER REFERENCES
Full Name: / Name / Email: / Email /
Company/Occupation: / Occupation / Phone: / Phone /
Relationship to You: / Relationship /
Full Name: / Name / Email: / Email /
Company/Occupation: / Occupation / Phone: / Phone /
Relationship to You: / Relationship /
Full Name: / Name / Email: / Email /
Company/Occupation: / Occupation / Phone: / Phone /
Relationship to You: / Relationship /
PROFESSIONAL REFERENCES
Full Name: / Name / Email: / Email /
Company/Occupation: / Occupation / Phone: / Phone /
Relationship to You: / Relationship /
Full Name: / Name / Email: / Email /
Company/Occupation: / Occupation / Phone: / Phone /
Relationship to You: / Relationship /
Full Name: / Name / Email: / Email /
Company/Occupation: / Occupation / Phone: / Phone /
Relationship to You: / Relationship /
Church: / Name of church you are part of / Denomination: / Denomination /
Name of Pastor: / Name / Address: / Address /
Are you a member?: / Membership / Phone: / Phone /
Pastor’s email: / Email /
RELATIONSHIP WITH CHRIST
Describe your relationship with Jesus Christ as you share the details of your personal testimony. If you prefer, you may answer these two questions in a separate Word document and add it as an attachment to your application e-mail. Please name the file as follows LAST NAME – FIRST NAME –RELATIONSHIP WITH CHRIST.doc
Personal Testimony /
  1. How have you grown as a Christian in the last five years? (Please answer in the space provided)

Growth in Christianity /
EDUCATIONAL PHILOSPHY
  1. Why do you feel called to be a teacher?
Personal Calling
  1. In what ways do you think you would be a good fit for Rosslyn Academy? In what ways might teaching at Rosslyn be a stretch for you?
Interest in teaching at Rosslyn
  1. Select a unit or topic that students often find difficult. Why do you think that is? What strategies do you employ to meet your students’ challenges?
Strategies
  1. Serving students outside the classroom is a vital part of teaching at Rosslyn Academy. In what ways would you love to serve students (eg. coaching, clubs, etc.)?
Co-curricular possibilities
  1. At Rosslyn Academy, our philosophy regarding faithful learning in the classroom is: “As faithful teachers and learners, we seek to glorify the triune God, the creator and redeemer of the universe, and the author of all Truth, by infusing our learning with opportunities to discover, explore, and apply the intimate relationship which exists between our faith, our academic subjects, and the rest of our lives.” In what ways could this take shape in the specific position(s) you are applying for?
Faithful learning
  1. What professional expertise do you bring that you would like to share with your colleagues in leading some PD training?
PD possibilities
STRENGTHS AND GROWTH
  1. Describe some helpful/constructive criticism you have received in the past few years, and identify steps you have taken to grow as a result.
Growth
  1. Describe a situation that you didn’t handle as well as you could have. How would you do things differently in the future?
Describe situation
  1. If youwere able to script your life exactly as you would like it to be, where might you be and what might you be doingin five years?In fifteen years?
Future
OTHER INFORMATION
Age of Parents (if living): / Father- / Age / Mother- / Age / Number of siblings: / Siblings /
Do you have financial obligations / YES
☐ / NO
☐ / Plans for maintaining while on assignment? / plans /
Have you or your spouse been under a physician’s care or received prescription medication in the past year? / YES
☐ / NO

Have you or your spouse ever tested positive for HIV/AIDS? / YES
☐ / NO

Have you or your spouse been diagnosed as having a degenerative disease? / YES
☐ / NO

Have you or your spouse ever had an emotional illness or received psychiatric care? / YES
☐ / NO

If you answered yes to any of the last 4 questions, please give details in the pace provided.
Details /
Have you or your spouse ever engaged in sexual abuse, physical abuse, or a pattern of emotional abuse? / YES
☐ / NO

Have you or your spouse ever received a verbal or written warning /reprimand or been convicted forpornography, any type of harassment, inappropriate language, dishonesty, or anyinappropriate actions involving a child? / YES
☐ / NO

Have you or your spouse ever been convicted of a crime, been fired from employment, or put on disciplinary leave within the last 10 years or previous two employers (whichever is longer)? / YES
☐ / NO

KENYAN CITIZENS ONLY
Do you have any experience teaching in a system other than 8-4-4? / YES
☐ / NO

Briefly describe your travels outside of Kenya.
Outside Kenya travels /
Describe your current salary and benefits package.
Package Description /
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. All questions have been accurately and fully answered. I am in possession of the degrees/certificates which I claim to hold.If this application leads to employment, I understand that any false or misleading information in my application or interview may result in my immediate termination.
Please type your name in lieu of a signature.
Signature: / Sign / Date: / Date /