Eustace ISD

Teacher Application

EUSTACE INDEPENDENT SCHOOL DISTRICT

AN EQUAL OPPORTUNITY EMPLOYER

TEACHER APPLICATION

DATE OF APPLICATION:

PERSONAL DATA

LAST NAME:

FIRST

MIDDLE

PRESENT ADDRESS:

OTHER ADDRESS WHERE YOU MAY BE REACHED

CELL PHONE

HOME PHONE

OTHER PHONE

EMAIL ADDRESS

OTHER NAME THAT MAY APPEAR ON RECORDS

ARE YOU RECEIVING TEXAS TEACHER RETIREMENT (TRS) BENEFITS?

YES

POSITION FOR WHICH YOU ARE APPLYING

CREDENTIALS INCLUDED WITH APPLICATION:

RESUME

COPY OF ALL TEACHING CERTIFICATES

COPY OF ALL TRANSCRIPTS SHOWING DEGREES

DATE AVAILABLE

FORMER EUSTACE ISD EMPLOYEE?

Reaquired field: YES

Reaquired field: NO

IF YOU ANSWERED YES, PROVIDE DATES OF EMPLOYMENT

EDUCATION

NAME AND LOCATION OF SCHOOL

COURSE OF STUDY MAJOR/MINOR FIELDS

DIPLOMA, DEGREE, OR CERTIFICATE

YEAR GRADUATED

NAME AND LOCATION OF SCHOOL

COURSE OF STUDY MAJOR/MINOR FIELDS

DIPLOMA, DEGREE, OR CERTIFICATE

YEAR GRADUATED

NAME AND LOCATION OF SCHOOL

COURSE OF STUDY MAJOR/MINOR FIELDS

DIPLOMA, DEGREE, OR CERTIFICATE

YEAR GRADUATED

CERTIFICATION

CERTIFICATES OR LICENSES CURRENTLY HELD:

NONE

VALID TEXAS

VALID OTHER STATE

TEXAS EMERGENCY

TEXAS ONE-YEAR

TEMPORARY ADMINISTRATIVE

OTHER STATES FOR VALID CERTIFICATES OR LICENSES

EXPIRATION DATES OF TEMPORARY CERTIFICATES

CATEGORY/LEVEL(S) OF CERTIFICATION:

AREAS OF SPECIALIZATION/SUPPLEMENTAL CERTIFICATES/ENDORSEMENTS (AS LISTED ON CERTIFICATION)

(IT WILL BE THE RESPONSIBILITY OF THE APPLICANT TO SECURE A STATE TEACHING CERTIFICATE FROM THE STATE EDUCATION AGENCY)

TEACHING EXPERIENCE - BEGIN WITH MOST RECENT

NAME AND LOCATION OF SCHOOL

TYPE OF ASSIGNMENT

DATES TAUGHT

PRINCIPAL'S NAME AND PHONE NUMBER

REASON FOR LEAVING

NAME AND LOCATION OF SCHOOL

TYPE OF ASSIGNMENT

DATES TAUGHT

PRINCIPAL'S NAME AND PHONE NUMBER

REASON FOR LEAVING

NAME AND LOCATION OF SCHOOL

TYPE OF ASSIGNMENT

DATES TAUGHT

PRINCIPAL'S NAME AND PHONE NUMBER

REASON FOR LEAVING

NAME AND LOCATION OF SCHOOL

TYPE OF ASSIGNMENT

DATES TAUGHT

PRINCIPAL'S NAME AND PHONE NUMBER

REASON FOR LEAVING

PLEASE LIST ANY RELEVANT SPECIALIZED TRAINING AND WORKSHOPS ATTENDED OR CONDUCTED

PLEASE PROVIDE A LIST OF OTHER JOBS OR ADMINISTRATIVE POSITIONS YOU HAVE HELD IN THE PAST 10 YEARS. ATTACH RESUME IF AVAILABLE.

EMPLOYER NAME AND LOCATION

POSITION/TITLE HELD

DATES EMPLOYED

SUPERVISOR'S NAME AND PHONE

REASON FOR LEAVING

EMPLOYER NAME AND LOCATION

POSITION/TITLE HELD

DATES EMPLOYED

SUPERVISOR'S NAME AND PHONE

REASON FOR LEAVING

EMPLOYER NAME AND LOCATION

POSITION/TITLE HELD

DATES EMPLOYED

SUPERVISOR'S NAME AND PHONE

REASON FOR LEAVING

EMPLOYER NAME AND LOCATION

POSITION/TITLE HELD

DATES EMPLOYED

SUPERVISOR'S NAME AND PHONE

REASON FOR LEAVING

PLEASE LIST REFERENCES THE DISTRICT CAN CONTACT REGARDING YOUR WORK HISTORY

NAME

SCHOOL DISTRICT/FIRM NAME

TELEPHONE NUMBER

POSITION

ADDRESS, CITY, STATE, ZIP

NAME

SCHOOL DISTRICT/FIRM NAME

TELEPHONE NUMBER

POSITION

ADDRESS, CITY, STATE, ZIP

NAME

SCHOOL DISTRICT/FIRM NAME

TELEPHONE NUMBER

POSITION

ADDRESS, CITY, STATE, ZIP

DO YOU HAVE A RELATIVE WHO SERVES ON THE BOARD OF EDUCATION OR IS AN EMPLOYEE OF EUSTACE ISD?

YES

IF YES, PLEASE PROVIDE THE NAME OF RELATIVE

RELATIONSHIP

POSITION HELD

HAVE YOU EVER BEEN CONVICTED OF, PLED GUILTY OR NO CONTEST (NOLO CONTENDRE) TO, OR RECEIVED PROBATION, SUSPENSION, OR DEFERRED ADJUDICATION FOR A FELONY OR ANY OFFENSE INVOLVING MORAL TURPITUDE (INCLUDING, BUT NOT LIMITED TO , THEFT, RAPE, MURDER, SWINDLING, AND INDECENCY WITH A MINOR)?

YES

IF YES, PLEASE STATE WHERE, WHEN, AND THE NATURE OF THE OFFENSE:

CONVICTION OF A FELONY IS NOT AN AUTOMATIC BAR TO EMPLOYMENT. THE DISTRICT WILL CONSIDER THE NATURE, DATE, AND RELATIONSHIP BETWEEN THE OFFENSE AND THE POSITION FOR WHICH YOU ARE APPLYING.

I HEREBY AFFIRM THAT ALL INFORMATION PROVIDED IN THIS APPLICATION IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT ANY DELIBERATE FALSIFICATIONS, MISREPRESENTATIONS, OR OMISSIONS OF FACT MAY BE GROUNDS FOR RECECTION OF MY APPLICATION OR DISMISSAL FROM SUBSEQUENT EMPLOYMENT I AUTHORIZE THE REFERENCES LISTED TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE ALL SUCH PARTIES FROM LIABILITY FOR ANY DAMAGE THAT MY RESULT FROM FURNISHING THE SAME TO YOU. I UNDERSTAND THAT THE DISTRICT IS REQUIRED BY TEXAS EDUCATION CODE TO REVIEW CRIMINAL HISTORY OF APPLICANTS.

SIGNATURE OF APPLICANT

PERSONAL COMMENTS

THIS APPLICATION BECOMES THE PROPERTY OF THE DISTRICT. THE DISTRICT RESERVES THE RIGHT TO ACCEPT OR REJECT IT. *APPLICATIONS FOR ALL POSITIONS ARE CONSIDERED WITHOUT REGARD TO RACE, COLOR, SEX (INCLUDING PREGNANCY), NATIONAL ORIGIN, RELIGION, AGE, DISABILITY, GENETIC INFORMATION, VETERAN OR MILITARY STATUS, OR ANY OTHER LEGALLY PROTECTED STATUS. ADDITIONALLY, THE DISTRICT DOES NOT DISCRIMINATE AGAINST AN APPLICANT WHO ACTS TO OPPOSE SUCH DISCRIMINATION OR PARTICIPATES IN THE INVESTIGATION OF A COMPLAINT RELATED TO A DISCRIMINATING EMPLOYMENT PRACTICE. THE DISTRICT TITLE IX COORDINATOR IS DR. COY HOLCOMBE 320 FM 316 S. EUSTACE, TEXAS 75124 903-425-5151.

REMINDERS TO APPLICANTS: ATTACH COMPLETE COPY OF TRANSCRIPT, ATTACH COPY OF TEACHER CERTIFICATE

Email a copy to

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Required Fields

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