TEACHER APPLICATION. Name. Current Address. City State Zip. How long have you lived at the above address?
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1 TEACHER APPLICATION APPLICATION DATE APPLICANT S INFORMATION Name Current Address City State Zip Home Phone Social Security Number Cell Phone How long have you lived at the above address? Please list any additional addresses where you have resided at any time during the past five years. Have you ever worked under a different name? Yes No If so, what was the name (or names)? Have you already signed a contract for next year with any another institution? Yes No How did you learn about this position? Please Note: If hired, you will be required to produce documents regarding your eligibility for employment in order to complete an I-9 form Revised March 2012 Page # 1
2 POSITION DESIRED Desired Employment Status: Full Time Part Time; Desired number of hours per week: Desired Location: Bremerton Campus Poulsbo Campus Desired Program: Academic Childcare Preschool Elementary Junior High High School Desired Position: Secondary Teacher; Subject(s): Elementary Teacher; Preferred Grade(s): Specialist Teacher; Subject(s): Coach; Sport(s): Substitute Teacher Preschool Teacher Other: Are you able to perform the tasks listed on the job description with or without accommodations? PROFESSIONAL QUALIFICATIONS What degree or degrees do you hold? Degree _ Date Received _ Issuing Institution Your Major(s) Your Minor(s) Cumulative grade point average: BA Graduate work Total (1 units after date of Bachelor s degree unit X = unit) Revised March 2012 Page # 2
3 Sequentially list your teaching experience with most recent first. School Name _ Grades or Subjects Dates Teaching Credentials: Do you have an ACSI Teaching Certificate? q Yes q No What level? Remains valid for how many years? Do you have a state teaching certificate? q Yes q No What state? What kind? Remains valid for how many years? Endorsement(s) List semester hours in endorsement area(s) If you do not hold a certificate, what requirements do you lack? Please attach photocopies of any certificates held. What computer programs and/or skills are you proficient in? Revised March 2012 Page # 3
4 EMPLOYMENT HISTORY Please start with your current or most recent employer and work backwards for the past ten years. If necessary, you may make copies of this page, or following the same format, use the reverse side. 1. Employer Okay to contact? q Yes q No Address_ Position_ Responsibilities Supervisor s Name Dates of Employment Reason for Leaving 2. Employer Okay to contact? q Yes q No Address_ Position_ Responsibilities Supervisor s Name Dates of Employment Reason for Leaving 3. Employer Okay to contact? q Yes q No Address_ Position_ Responsibilities Supervisor s Name Dates of Employment Reason for Leaving Revised March 2012 Page # 4
5 PERSONAL REFERENCES What church are you currently attending? Please list your Pastor s name and contact information: Name Please sign the Authorization to Release Reference Information form that is included in this packet and return it with this application. Do not list family members or relatives for references. Give three references who are qualified to speak of your spiritual experience and character. 1. Name_ 2. Name_ 3. Name_ Give three references that are qualified to speak of your professional training and experience. List your current or most recent principal or supervisor first. 1. Name_ 2. Name_ 3. Name_ Revised March 2012 Page # 5
6 APPLICANT S CERTIFICATION AND AGREEMENT I understand that Gateway Christian Schools does not discriminate in its employment practices against any person because of race, color, national or ethnic origin, gender, age, or disability. I hereby certify that the facts set forth in this initial application are true and complete to the best of my knowledge. I understand that discovery of falsification of any statement or a significant omission of fact may prevent me from being hired, or if hired, may subject me to immediate dismissal regardless of the time elapsed before discovery. If I am released under these circumstances, I further understand that I will be paid and receive benefits only through the day of release. I authorize Gateway Christian Schools to thoroughly investigate references, work records, evaluations, education, and other matters related to my suitability for employment. I authorize references and my former employers to disclose to the church or schools any and all employment records, performance reviews, letters, reports, and other information related to my life and employment, without giving me prior notice of such disclosure. In addition, I hereby release Gateway Christian Schools, my former employers, references, and all other parties from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure. I waive the right to ever personally view any references given to Gateway Christian Schools. Since I will be working with children, I understand that I may be asked to submit to a fingerprint check by the FBI and possibly other federal and state authorities. I agree to fully cooperate in providing and recording as many sets of my fingerprints as are necessary for such an investigation. I authorize Gateway Christian Schools to conduct a criminal records check. I understand that this is only an application for employment and that no employment contract is being offered at this time. I certify that I have carefully read and do understand the above statements. Applicant s Signature Date AUTHORIZATION TO RELEASE REFERENCE INFORMATION I have made application for a position as a with Gateway Christian Schools. I have authorized the school to thoroughly investigate references, work records, evaluations, education, and other matters related to my suitability for employment. I authorize references and my former employers to disclose to the school any and all employment records, performance reviews, letters, reports, and other information related to my life and employment, without giving me prior notice of such disclosure. In addition, I hereby release Gateway Christian Schools, my former employers, references, and all other parties from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure. I waive the right to ever personally view any references given to Gateway Christian Schools. I certify that I have carefully read and do understand the above statements. Applicant s Name (Printed) Date Revised March 2012 Page # 6
7 INTERVIEW PREPARATORY QUESTIONS SPIRITUAL BACKGROUND Describe your relationship with Christ. Please carefully read our Statement of Faith and indicate your degree of support. GATEWAY CHRISTIAN SCHOOLS STATEMENT OF FAITH We believe the Bible to be the inspired, the only infallible and authoritative Word of God. We believe there is one God, eternally existent in three persons: Father, Son and Holy Spirit. We believe in the deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through His shed blood, in His bodily resurrection, in His ascension to the right hand of the Father, and in His personal return in power and glory. We believe in the resurrection of both the saved and the lost; they that be saved unto the resurrection of life, and they that are lost unto the resurrection of damnation. We believe in the spiritual unity of believers in our Lord Jesus Christ. We believe in the present ministry of the Holy Spirit by indwelling the Christian, enabling him to live a godly life. q q I fully support the statement as written without mental reservations. I support the statement except for the area(s) listed and explained on a separate paper. The exceptions represent either disagreements or items for which I have not yet formed an opinion or conviction. DECLARATION OF MORAL INTEGRITY Gateway Christian Schools expects all of its employees, as well as its volunteers who have unsupervised access to children, to model the same Christian values and lifestyle that it seeks to inculcate in its students. As an applicant for a ministry position, as an employee, or as a volunteer at this school, I, (print name), recognize, understand, and agree to live by the Christian moral standards of the school. I declare that as a follower of Christ, I am not engaging in and commit to not engage in inappropriate sexual conduct. Inappropriate conduct includes, but is not limited to, such behaviors as the following: heterosexual activity outside of marriage (e.g. premarital sex, cohabitation, extramarital sex), homosexual activity, sexual harassment, use of (including the viewing of) pornographic material or websites, and sexual abuse or improprieties toward minors as defined by Scripture and federal or state law. I declare that the above statement is factual and true. My signature below indicates that I meet moral integrity standards and Christian role model lifestyle requirements of this Christian school. Applicant s Signature Administrator s Signature (after discussion with applicant) Date Date Revised March 2012 Page # 7
8 On separate paper, please answer the following questions concisely, using no less than two sentences or no more than two or three paragraphs per question. Personal background 1. Tell us about yourself. (Include information about high school, college, activities, honors, student teaching assignment, work experience, etc.) 2. What are your career goals (short and long-term)? INSTRUCTION, CURRICULUM & ASSESSMENT 3. How do kids learn? 4. What three expectations do you have of your students? 5. Give several examples of how you have instructionally designed your lessons to met the varying ability levels of your students (low, average, high). 6. Tell us more about your instructional style. How do you teach? What would we see in your classroom? 7. How do you incorporate technology into your instruction? 8. How do you incorporate thinking skills into your class? 9. What is the purpose of homework? 10. Describe a typical homework assignment. 11. What is the goal of your instruction? 12. How do you motivate the unmotivated? 13. What is unique about your approach to teaching? CLASSROOM MANAGEMENT 14. How do you begin each class? 15. Tell us how you have handled a student that was repeatedly disruptive in the classroom. 16. How do you promote acceptance, tolerance, and diversity in your classroom? 17. How would you approach a parent who was upset or angry? 18. Describe the toughest students you have had to deal with, and how you resolved the situation. PROFESSIONAL IDENTITY, CARE & DEVELOPMENT 19. What do you read to stay current in your field? 20. Think of your best teachers. What positive characteristics do you believe these teachers demonstrated? Which of these characteristics do you believe you have? 21. What do you feel is your greatest strength? Weakness? 22. Why do you feel you are the best candidate for the position? GENERAL INFORMATION 23. Are you currently interviewing for other positions? 24. Do you have any questions for us? 25. Are there any final comments regarding your pursuit of this position that you would like to share with us. Revised March 2012 Page # 8
9 FOR OFFICE USE ONLY Date Received CV Received Criminal Background Check Complete Acknowledgement Letter Sent Initial Interview Scheduled Certifications Attached Revised March 2012 Page # 9
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