APPLICATION AGAPE ACADEMY

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1 APPLICATION AGAPE ACADEMY

2 AGAPE ACADEMY PO BOX LITTLE ROCK, AR Position Applying For: PERSONAL DATA: DATE: Legal Name Social Security Number Preferred Name Phone (1) Phone (2) Address City State Zip Length of time at this address? Preferred Single Engaged Married Divorced Widow(er) Desired class level to teach: 3-K Grade or subject in order of preference: (1) (3) (2) (4) Please list activities or sports that you would be capable of or interested to direct: (Indicate grade or level abilities) Sponsor, advice, or coach Have you even been dismissed, resigned to avoid being dismissed, or been asked to resign from a position? Yes No If Yes, please explain: 2

3 Why are you interested in teaching at Agape Academy? Names of Agape Church members you may know: References: Name Phone address Occupation List three professional references who are qualified to speak of your professional training and experience. List first, your current or most recent principal or supervisor: Name Phone address Occupation Professional Qualifications: Please attach photocopies of all your college transcripts. Please attach copies of any certificates. Degree(s) you hold Date received Issuing Institution _ Major(s) Minor(s) Cumulative Grade Point Average: Undergraduate: Graduate: 3

4 Have you ever been convicted of an offense involving dishonesty, breach of trust, child abuse or any felony? Yes No If yes, Please explain Teaching Experience - List your teaching experience(s) with the most recent first: Dates School Grade/Subject Club/Sport Number of years teaching experience: Public Private Christian TOTAL Are you under contract for the coming school year? Yes No Reason for leaving your most recent position? _ List other work or military experiences that may have significance for the type of position you are applying: Dates Place Type or work or experience Have you had any courses in the Christian philosophy of education? If so, where and when? 4

5 Have you had any courses giving specific training for Christian schools? List any conferences in which you have participated or led: List any other teaching experiences you have had, including opportunities for travel: List books, blogs, articles, DVD s, etc. that have helped you grow professionally: Do you have a State Teaching Certificate? Yes No What kind? Expires Endorsement(s): List semester hours in Endorsement area: If you do not hold a license, what requirements do you lack? Personal Interest Data: List memberships, offices, and honors obtained: Current College High School List Hobbies and Personal interest s 5

6 Christian Background: CHURCH: Church Attending: Denomination preference: Are you a member in good standing? How long? Church activities involved in, and with what degree of regularity: Involvement in other ministry services: DEVOTIONAL LIFE: Describe your daily time of Bible study and prayer: Other than the Bible, what books have influenced your life spiritually? _ On a separate piece of paper, please answer the following: (1) Your conversion experience: (2) Comment on your spiritual growth: (3) Why do you wish to teach at Agape Academy? (4) What distinguishes a Christian school from a secular school, public or private? (5) What do you consider to be the proper classroom atmosphere for learning? (6) What are your areas of strength? And weaknesses? (7) Luke 6:40 says when a pupil is fully trained, he/she will be like his teacher. Please share what this means to you in your personal habits, values, recreation and all-encompassing life-style: (8) Any additional information you would like to share regarding your candidacy for this position: 6

7 PRIVATE RELIGIOUS ORGANIZATION DISCLOSURE As a private Christian school, Agape Academy is a religious organization. While commerce laws prohibiting arbitrary discrimination on the basis of race, color, sex, national origin, age and disability apply generally to religious organizations, a religious organization is allowed to discriminate on the basis of its religious beliefs. This exception is rooted in the constitutional right to free exercise of religion. As a private school, Agape Academy considers academic performance to be criteria relevant to decisions regarding student admission and retention. As a religious organization, Agape Academy will neither commence nor continue admission, enrollment or employment if it is believed by Agape Academy that such will cause confusion about, conflict with, or compromise of the schools mission to provide a distinctly Christian education from a Christ-centered worldview. In that regard, Agape Academy conforms to the orthodox teachings of the historical Christian Church as set forth in the sixty-six books of the Holy Bible, all of which we believe to be our infallible and authoritative rule of faith and practice. Any decision to discriminate on the basis of religious belief will be made by the Head of School, subject to review by the Board of Trust. This policy applies to and is incorporated into all Agape Academy affairs, including all Agape Academy contracts, programs, activities, facilities, publications, and events. DOCTRINAL STATEMENT Please carefully read our Doctrinal Statement and indicate below your degree of support: A. We believe that the Bible, consisting of 66 books of the Old and New Testaments, verbally inspired, free from error in doctrine, fact and ethic, and inerrant in the original writings, is the word of God and the only infallible and authorative rule of faith and practice. B. We believe in the Holy Trinity, one God eternally existent in the three persons - Father, Son, and Holy Spirit - same substance, equal in power and glory. C. We believe in the deity of our Lord Jesus Christ, His virgin birth, His sinless life, His miracles, His vicarious and atoning death, His bodily resurrection, His ascension to the right hand of God the Father, and of his personal physical return in power and glory. D. We believe that God created man in His own image but that through sin, man brought upon himself and his posterity not only physical death, but also spiritual death which is separation from God; that all human beings by physical birth possess a sinful nature. E. We believe that the salvation of lost and sinful man is a free gift of God s grace apart from works, based solely upon Christ s vicarious and atoning death, effected by the regenerating work of the Holy Spirit and received by trusting in Christ s finished work on the cross, and that this salvation is eternally secured to all believers. F. We believe in the present ministry of the Holy Spirit, by Whose indwelling upon salvation the Christian is enabled to live a godly life, that it is incumbent upon every believer to walk worthy of his calling - to walk after the Spirit and not after the flesh. G. We believe in the resurrection of the body of both the saved and the lost - they that are saved to the resurrection of life everlasting and they that are lost to the resurrection to eternal damnation. H. We believe in the spiritual unity of believers in the Lord Jesus Christ. I fully support the Disclosure Statement and the Doctrinal Statement as written, without reservations: Signed Date 7

8 I support the Disclosure Statement and/or the Doctrinal Statement except for the areas listed and explained below. The exceptions represent either disagreements or items for which I have not yet formed an opinion or conviction. Signed Date Applicant s Certification and Agreement: I understand that Agape Academy does not discriminate in its employment practices against any person because of age, race, color, national or ethnic origin, gender, or handicap. I further understand that any offer of employment is conditioned on the proof of legal authority to work in the U.S. as well as conditioned on the results of pre-employment drug screening. I also recognize, understand, and adhere to the moral and ethical standards and mandates of this school. I further declare that in regard to my personal moral and ethical character and conduct as of this date, I am not, nor have been in the past, engaged in inappropriate conduct toward minors, nor do I have inclination toward such conduct. INAPPROPRIATE CONDUCT INCLUDES the following: homosexuality; verbal, physical or sexual abuse, as defined by scripture and state law. I hereby certify that the facts set forth in this application are true and complete to the best of my knowledge. I understand that discovery of falsification of any statement or significant omission of fact during any phase of the hiring process may prevent me from being hired or if hired, may subject me to immediate dismissal. I authorize Agape Academy to inquire about my work and personal history and to verify all data given for employment, related papers, and my oral interviews. I authorize the release and giving of any information requested such as employment records, performance reviews, and personal references whether such information is favorable or unfavorable to me. Pursuant to this application only, I release any person, organization or company from liability claims or damages that may directly or indirectly result from the use, disclosure, or release of any such information whether this information is favorable or unfavorable to me. I further wave the right to ever personally review any references given. I, the undersigned, affirm the accuracy of all responses set forth in this application. Signature Date PLEASE ATTACH RESUME 8

9 AGAPE ACADEMY AUTHORIZATION / CONSENT During the application process and any time during the tenure of my employment/services with Agape Academy, I hereby authorize First Advantage, on behalf of Agape Academy to procure a consumer report (known as an investigative consumer report in California) which I understand may include information regarding to my character, general reputation, or personal characteristics. The report may be compiled with information from courts record repositories, departments of motor vehicles, past or present employers and education institutions, governmental occupational licensing or registration entities, business or personal references and any other source required to verify information that I have voluntarily supplied. I understand that I may request a complete and accurate disclosure of the nature and scope of the background verification; to the extent such investigation includes information bearing on my character, general reputation, or personal characteristics. Applicant/Employee Signature - - Social Security Number* Date Date of Birth Printed Name Street Address City, State, Zip * For identification purposes only BACKGROUND VERFICATION DISCLOSURE This is used to inform you that a consumer report is being obtained from a consumer reporting agency for the purpose of evaluating you for employment, volunteer service, or a contracted position, including retention as an employee, volunteer, or independent contractor. This report may contain information bearing on your character, general reputation, and personal characteristics from public or private record sources. 9

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