Wink-Loving Independent School District

WINK-LOVING INDEPENDENT SCHOOL DISTRICT

P. O. Box 637

WINK, TEXAS 79789-0637

APPLICATION

TO ALL APPLICANTS:

Application must be completed in FULL. Use a pen or typewriter.
If space is not sufficient for a complete answer, use a separate sheet.

Send completed application and resume to: / Scotty Carman, Superintendent
Wink-Loving I.S.D.
P.O. Box 637
Wink, Texas 79789-0637

Application for the Position of

Name

Social Security No.

Address

/ /

Telephone

/ /

(Home)

Telephone

/ /

(Work)

DATE YOU CAN START

/ /

HAVE YOU BEEN CONVICTED OF A FELONY WITHIN THE LAST SEVEN YEARS?

IF YES, DESCRIBE BELOW.

CERTIFICATES HELD

HOW DID YOU LEARN ABOUT THIS JOB?

Recruitment Notice
Newspaper
Professional Publication
Telephone Call
Other (specify)

SALARY DESIRED

/ /

REFERENCES:

GIVE FULL NAME AND ADDRESS OF EACH REFERENCE. IN NAMING REFERENCE, IF YOU HAVE HAD TEACHING EXPERIENCE, GIVE SUPERVISORS, PRINCIPALS, AND SUPERINTENDENTS WHO ARE FAMILIAR WITH YOU. THE JUDGMENT OF A NON-PROFESSIONAL PERSON IN REFERENCE IS USUALLY VALUABLE ONLY FROM THE STANDPOINT OF GENERAL CHARACTER.

NAME / ADDRESS / TELEPHONE NUMBER / OCCUPATION

My placement papers are being sent. YesNoDate Requested:

My transcripts are being sent.Date requested:

GENERAL INFORMATION:

Within reasonable limits are you willing to participate in in-service programs to improve your competency?

Within reasonable limits are you willing to assist in curriculum evaluation and revision?

Are you a member of any professional, community, or service organizations?

List any relatives working in this School District:

List any extra-curricular activities that you may be interested in sponsoring or assisting:

List all subjects you can teach:

What Professional Conferences have you attended in the last two years?

EDUCATION PREPARATION: Be definite as to dates, degrees and semester hours.

NAME OF SCHOOL / LOCATION / DATES / DEGREE OR NO. OF HOURS
H. S.:
COLLEGES:
FIRST MAJOR / SEM HRS. / SECOND MAJOR
FIRST MAJOR / SEM HRS. / SECOND MAJOR
SEM.HRS. IN EDUCATION / HIGHEST DEGREE RECEIVED

EXPERIENCES:

YEARS / LOCATION / POSITION HELD / SALARY HELD
- / $
- / $
- / $
- / $
- / $
- / $
- / $
- / $
- / $
- / $
- / $

TOTAL YEARS EXPERIENCE IN TEACHING

EXPLAIN WY YOU ARE APPLYING FOR THIS POSITION:

BRIEFLY EXPLAIN YOUR PHILOSOPHY OF EDUCATION:

YOU MAY CONTACT:

PRESENT EMPLOYER YES NOFORMER EMPLOYERS YESNO

I HEREBY CERTIFY THAT THE FOREGOING STATEMENTS AS WELL AS THOSE ON ANY ATTACHMENT(S) TO THIS FORM ARE TO THE BEST OF MY KNOWLEDGE TRUE AND CORRECT AND THAT THEY ARE ALL GIVEN OF MY OWN FREE WILL. I AGREE THAT ANY MISSTATEMENT(S) OR OMMISSION(S) AS TO MATERIAL FACTS WILL CONSTITUTE GROUNDS FOR UNFAVORABLE CONSIDERATION OR DISMISSAL FROM EMPLOYMENT. I UNDERSTAND THAT I AM NOT ELIGIBLE FOR EMPLOYMENT UNLESS COPIES OF TRANSCRIPTS AND CERTIFICATES OF ALL EDUCATIONAL TRAINING BEYOND THE HIGH SCHOOL LEVEL ACCOMPANY THIS APPLICATION. IT IS ALSO UNDERSTOOD THAT REPRODUCTIVE COPIES OF ALL SUBSTANTIATING DOCUMENTS ARE ACCEPTABLE. MY APPLICATION WILL BE RE-TAINED IN THE ACTIVE FILE FOR THREE MONTHS AND MAY BE REACTIVITATED BY SENDING A WRITTEN REQUEST TO THE SUPERINTENDENT OF SCHOOLS BEFORE THE END OF THE THREE MONTH PERIOD.

APPLICANT’S SIGNATURE DATE

WINK-LOVING INDEPENDENT SCHOOL DISTRICT IS AN EQUAL EDUCATION AND EMPLOYMENT OPPORTUNITY EMPLOYER.

WINK-LOVING INDEPENDENT SCHOOL DISTRICT

OFFICE OF THE SUPERINTENDENT

P.O. BOX 637

WINK, TEXAS 79789-0637

ADDENDUM TO EMPLOYMENT APPLICATION

CRIMINAL HISTORY RECORD INFORMATION

USER NUMBER:1201E

The Wink-Loving Independent School District is required by sate law to obtain criminal history record information on all applicants for employment with the district (Texas Education Code Section 21.917).

I understand the information set forth below will be used by the district solely for the purpose of obtaining criminal history record information and will not be used in any manner related to determining eligibility for employment with the district.

Full Name

(Print)LastFirstMiddle

Social Security No.

Driver License # ______

Date of Birth

SexMaleFemale

Ethnicity:BlackHispanic

WhiteOther

Signature

This form will be removed from the application and filed separately in the Administrative Office.