Lafayette County School District

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Certified Opportunities Application

Employment Opportunity

Lafayette County School District is an Equal Opportunity Employer.
For more information, qualified applicants may contact the Administration Office at 870-921-5500, 712 Chestnut St. Lewisville, AR. Applications will be accepted until positions are filled at the Adminstration Office or by mail to P.O. Box 950, Lewisville, AR 71845.

Certified Staff Application

Lafayette County School district

AN EQUAL OPPORTUNITY EMPLOYER

PERSONAL DATA

LAST NAME:

FIRST

MIDDLE

Phone Number

SOCIAL SECURITY NUMBER:

Email:

Reaquired field: PRESENT ADDRESS

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

DATE OF APPLICATION:

START DATE AVAILABLE :

POSITION DESIRED: INDICATE SCHOOL LEVELS AND SUBJECT AREAS IN WHICH YOU ARE PREPARED TO TEACH. GIVE PREFERENCE BY RANKING IN THE APPROPRIATE LEVEL OR SUBJECT AREA.

Check the extra-curricular activities or clubs which you would be willing to sponsor.

EDUCATIONAL AND PROFESSIONAL PREPARATION

LAST ELEMENTARY ATTENDED

CITY, STATE

DATES ATTENDED

LAST HIGH SCHOOL ATTENDED

CITY, STATE

DATES ATTENDED

DIPLOMA OR DEGREE

COLLEGE OR UNIVERSITY

CITY, STATE

DATES ATTENDED

DIPLOMA OR DEGREE

COLLEGE OR UNIVERSITY

CITY, STATE

DATES ATTENDED

DIPLOMA OR DEGREE

WHAT IS YOUR OVERALL COLLEGE GRADE-POINT AVERAGE? (EXAMPLES:2.8/4.0; 2.8/3.0) OPTIONAL

STUDENT TEACHING:

Reaquired field: YES

Reaquired field: NO

GRADE OR SUBJECT IN WHICH YOU DID STUDENT TEACHING

GRADE EARNED

SCHOOL

CITY, STATE

YEAR

PLEASE LIST ALL INFORMATION CONCERNING ARKANSAS TEACHER CERTIFICATION HELD:

Do you hold or have you held Arkansas teaching certification?

Reaquired field: Yes

Reaquired field: No

Type

Reaquired field: Initial

Reaquired field: Standard

Reaquired field: Non-Traditional

Reaquired field: None

CERTIFICATION AREAS

DATE ISSUED

VALID UNTIL

Do you hold or have you held teaching certification in another state?

Reaquired field: Yes

Reaquired field: No

If yes, list your areas of certification

If you do not currently hold a teaching certificate, describe your status:

TEACHING EXPERIENCE

DATES EMPLOYED

NAME OF SCHOOL, CITY, STATE

GRADES & SUBJECTS TAUGHT

REASON FOR LEAVING

DATES EMPLOYED

NAME OF SCHOOL, CITY, STATE

GRADES & SUBJECT TAUGHT

REASON FOR LEAVING

DATES EMPLOYED

NAME OF SCHOOL, CITY, STATE

GRADES & SUBJECTS TAUGHT

REASON FOR LEAVING

ARE YOU EMPLOYED IN A SCHOOL DISTRICT NOW?

Reaquired field: YES

Reaquired field: NO

ADDITIONAL INFORMATION

HAVE YOU EVER BEEN CONVICTED OF A FELONY ?

Reaquired field: YES

Reaquired field: NO

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

Have you ever failed to be rehired?

Reaquired field: Yes

Reaquired field: No

If so, Where?

Are you currently on the child maltreatment registry?

Reaquired field: Yes

Reaquired field: No

Are you a veteran, disabled veteran or surviving spouse?

Reaquired field: Yes

Reaquired field: No

ALL PERSONNEL OF THE SCHOOL DISTRICT, REGARDLESS OF CLASSIFICATION, ARE EMPLOYED, SUBJECT TO ASSIGNMENT, AND/OR REASSIGNMENT BY THE SUPERINTENDENT OR BY HIS OFFICIAL DESIGNATED REPRESENTATIVE BASED UPON THE NEEDS OF THE DISTRICT. DO YOU UNDERSTAND IF EMPLOYED YOU ARE SUBJECT TO REASSIGNMENT AS NEED ARISES?

Reaquired field: YES

Reaquired field: NO

REFERENCES (GIVE AT LEAST FIVE REFERENCES INCLUDING SUPERINTENDENTS AND PRINCIPALS FOR WHOM YOU HAVE MOST RECENTLY WORKED AND ONE ADDITIONAL PERSON WHO CAN ATTEST TO YOUR CHARACTER AND QUALIFICATIONS.)

NAME

TELEPHONE NUMBER

POSITION

ADDRESS, CITY, STATE, ZIP

NAME

TELEPHONE NUMBER

POSITION

ADDRESS, CITY, STATE, ZIP

NAME

TELEPHONE NUMBER

POSITION

ADDRESS, CITY, STATE, ZIP

NAME

TELEPHONE NUMBER

POSITION

ADDRESS, CITY, STATE, ZIP

NAME

TELEPHONE NUMBER

POSITION

ADDRESS, CITY, STATE, ZIP

Please respond to the following. Explain why you chose to enter the teaching profession and why you would like to teach in Lafayette County School District.

DO YOU HAVE ANY ADDITIONAL INFORMATION YOU FEEL WILL HELP US MAKE A BETTER DECISION IN OUR CONSIDERATION OF YOU FOR A POSITION.

REMINDERS TO APPLICANTS: ATTACH A COMPLETE COPY OF YOUR TRANSCRIPT AND A COPY OF YOUR TEACHER CERTIFICATE

Attachments

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Read Carefully before Signing

Placement credentials, photocopy of teaching certificate, and an official transcript of all college or university credit should be forwarded to: Superintendent, Lafayette County School District, P.O. Box 950, Lewisville, Arkansas 71845. IF NOT ATTACHED ABOVE. Application forms are sent to all who request them regardless of existing vacancies. The issuance of such forms does not signify that the applicant is under consideration for appointment. The applicant will be notified when an initial interview is scheduled. An application remains active for a period of three years and must be renewed following this period. The facts set forth in my application for employment shall be considered true and complete. I understand that, if employed, false statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice. I also agree to take any medical examination required by the school district. I waive the right to view or examine any personal or employment reference forms that are completed and returned to the district by the persons whom I list as references on this application.

Do you agree to this contract? (type yes or no) Max: 1

SIGNATURE OF APPLICANT

Required Fields