GREEN PASTURES CHRISTIAN SCHOOL Application for Employment Date Directions: Please complete this form in ink. The previous employment section should be completed as much as possible. All information will be held in confidence. Personal Information Name SS# Mailing Address Phone # City State Zip Code Date of Birth (month/day/year) Height Weight Marital Status: Married Single Widow Divorced Number of Children Ages Spouse s Name Maiden Name of Wife Educational Information List all educational institutions above high school you attended: Trade/Technical School Address Years (from - to) Degree College Graduate or Other 5455 Flat Shoals Parkway Decatur, Georgia 30034 (770) 987-8121, Ext. 100
(UNDERGRADUATE) Major No. of Credits Grade Point Average Minor No. of Credits Gr. Pt. Avg. Education Christian Education Bible Other Field GRADUATE Education Christian Education Bible Other Field Please attach a copy of your college transcript(s). If you did not earn an education degree, list education courses taken. Please list any academic/athletic honors, extra-curricular activities or offices held. Hobbies Teacher Certification (if not - please explain) Kind of Certificate State # Valid Until Practice Teaching (subject and place) 2
Critique Teacher Address School Please attach a copy of your certificate. Professional Teaching Experience Address (City/State) Date (From - To) Position/Subjects Taught Grades Present Salary (Annual) $ List briefly experience with children other than teaching: Employment Information (other than education) Employer Address (City/State) Position Date (From - To) Supervisor Reason Left Placement Information What position do you desire at Green Pastures Christian Schools? What grades or subjects are you prepared to teach? 3
Why What other school activities could you sponsor or assist? Christian School Information Have you had any courses in Christian Philosophy of Education? When? Where? Would you regularly follow a reading program or correspondence course on this topic? Have you had other courses giving specific training for Christian schools? When? Where? Name of Courses Instructor What do you consider to be the distinctive characteristic of the Christian school? 4
How would your teaching of subject matter in a Christian school differ from your teaching of it in a non- Christian school? As a teacher in a Christian school, on what basis would you require obedience from your pupils? Please comment on the Lord s leading in your life toward Christian school teaching. Spiritual Information Church Home Address Denomination Church now attending Are you an active member? Yes No Have you accepted Jesus Christ as your personal Lord and Savior? Yes No Date What is God saying to you and doing in your life at the present time? 5
State any type of Christian service you have been involved in: Do you without reservation subscribe to the statement of faith of Green Pastures Christian Ministries? (See back sheet) Yes No Do not understand. Health Information General Condition of Health: Excellent Good Fair Poor Do you consider your health adequate for intensive school teaching? Job attendance during the last year: Excellent Good Fair Poor Are you allergic to any antibiotics or other medication? (specify) An annual physical exam is required for all employees. Health records, as with all other materials submitted in application to Green Pastures Christian Schools, are considered confidential and are not released without employees consent. References List three persons who have been acquainted with your professional experience. Name Address Occupation Telephone # 6
Please forward three typewritten letters of recommendation from references who are qualified to speak of your home background, Christian life, training and/or experience. I hereby declare that, to the best of my knowledge, the above statements and information are accurate. I understand that the deliberate falsification or misrepresentation of aforesaid statements and information, will be sufficient grounds of subsequent dismissal, should I be employed. I also acknowledge that I am aware that all information will be verified, and I do give my consent for this purpose. I understand that should I become employed at Green Pastures Christian Ministries, Inc. I will have a 90 day probation period. Applicant s Signature Date Office Use Only ITEM DATE RECEIVED 1. Application... 2. Letters of Recommendation... 3. Reference Letters... 4. College Transcripts... 5. Teacher Certification... 6. Application Renewed... 7. Interviews Scheduled... 8. Letter of Employment/Non-Employment... 9. Loyalty Requirement... 10. Statement of Faith... 11. Standards of Conduct... 12. Hire Data Sheet... 13. Personnel Policies Sheet... 14. Contract Signed... COMMENTS: GPCS Employment Application (6/16/00) 7