Eustace ISD

Please Fill Out The Auxiliary Application Below

EUSTACE INDEPENDENT SCHOOL DISTRICT

AN EQUAL OPPORTUNITY EMPLOYEE

AUXILIARY EMPLOYMENT APPLICATION

DATE:

NAME: (LAST, FIRST, MIDDLE)

ADDRESS, CITY, STATE, ZIP:

ALTERNATE ADDRESS, CITY, STATE, ZIP:

HOME TELEPHONE:

MOBILE TELEPHONE

EMAIL ADDRESS

YES

OTHER NAME THAT MAY APPEAR ON RECORDS

ARE YOU RECEIVING TEXAS TEACHER RETIREMENT (TRS) BENEFITS?

YES

EMPLOYMENT DESIRED

POSITION FOR WHICH YOU ARE APPLYING

TYPE OF EMPLOYMENT

FULL-TIME

PART-TIME

SUMMER ONLY

DATE YOU CAN START:

SPECIAL SKILLS

LIST SPECIFIC SKILLS, SOFTWARE PROFICIENCY, AND ANY MACHINES OR EQUIPMENT YOU CAN OPERATE. INCLUDE NUMBER OF YEARS OF EXPERIENCE.

WORK EXPERIENCE Please provide a complete list of all positions you have held in the past 10 years. List the most recent first. Attach additional sheets if necessary. 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

EDUCATION

NAME AND LOCATION SCHOOL ATTENDED

COURSE OF STUDY AND MAJOR/MINOR

DIPLOMA, DEGREE, CERTIFICATE, OR LICENSE GRANTED

YEAR GRADUATED

NAME AND LOCATION OF SCHOOL ATTENDED

COURSE OF STUDY AND MAJOR/MINOR

DIPLOMA, DEGREE, CERTIFICATE, OR LICENSE GRANTED

YEAR GRADUATED

NAME AND LOCATION OF SCHOOL ATTENDED

COURSE OF STUDY AND MAJOR/MINOR

DIPLOMA, DEGREE, CERTIFICATE, OR LICENSE GRANTED

YEAR GRADUATED

NAME AND LOCATION OF SCHOOL ATTENDED

COURSE OF STUDY AND MAJOR/MINOR

DIPLOMA, DEGREE, CERTIFICATE, OR LICENSE GRANTED

YEAR GRADUATED

REFERENCES Please list references the district can contact regarding your work history..

NAME

BUSINESS

POSITION/TITLE

TELEPHONE NUMBER

MAILING ADDRESS

NAME

BUSINESS

POSITION/TITLE

TELEPHONE NUMBER

MAILING ADDRESS

NAME

BUSINESS

POSITION/TITLE

TELEPHONE NUMBER

MAILING ADDRESS

NAME

BUSINESS

POSITION/TITLE

TELEPHONE NUMBER

MAILING ADDRESS

GENERAL INFORMATION

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 RELATIVE'S NAME AND RELATIONSHIP

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, STATE WHERE, WHEN, AND THE NATURE OF THE OFFENSE:

A FELONY CONVICTION 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 rejection of my application of dismissal from subsequent employment. I authorize the references listed on the previous page 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 may result from furnishing the same to you. I understand that the district is required by Texas Education Code to review criminal history of applicants.

DATE:

SIGNATURE

Applicants 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 a discriminating employment practice.

RESUME

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PERSONAL COMMENTS

The district Title IX Coordinator is Dr. Coy Holcombe 320 FM 316 S. Eustace, Texas 75124 903-425-5151.

This application becomes the property of the district. The district reserves the right to accept or reject it.

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