Date: Scial Security #: PERSONAL INFORMATION Name: Last First Middle Identity must be cnfirmed with a state driver s license r ther phtgraphic identificatin. Physical : City Zip Mailing : City Zip (if different frm abve) Hme Phne #: Cell Phne #: Please indicate the age f student s yu prefer t wrk with: Psitin applying fr: Please indicate the date yu wuld be available t begin: Have yu ever been cnvicted f r pleaded guilty t a crime? Yes N (If yes, please explain, attach a separate page, if necessary) D yu have a current driver s license? Yes N D yu smke? Yes N D yu drink? Yes N D yu have a histry f illegal drug use? Yes N 1 P a g e
EDUCATIONAL DATA Name f High Schl Year f Graduatin List the educatinal institutins abve high schl yu have attended. Give dates and degrees. A cpy f yur transcript and diplma shuld be prvided. Institutin Name Year Cmpleted Majr Degree Institutin Name Year Cmpleted Majr Degree Are yu certified t teach in Alabama? Yes N EMPLOYMENT DATA Have yu ever been dismissed frm a jb? Yes N (If yes, please explain, attach a separate page, if necessary) List places f emplyment with current r mst recent psitin first: 1. Emplyer Start End Psitin Held Duties Held Reasn fr leaving 2 P a g e
2. Emplyer Start End Psitin Held Duties Held Reasn fr leaving Please use additinal pages if needed. I give permissin fr my previus emplyers t be cntacted Yes N If n, please explain Name f church f which yu are a member: CHURCH HISTORY AND PRIOR YOUTH WORK List name and address f ther churches yu have attended regularly during the past five years: List all previus children s wrk invlving yuth (list each rganizatin s name and address, type f wrk perfrmed, and dates): 3 P a g e
List any gifts, callings, training, educatin, r ther factrs that have prepared yu fr children r yuth wrk: 1. Name Phne Number 2. Name Phne Number 3. Name Phne Number PERSONAL REFERENCES Please d nt use frmer emplyers r relatives 4 P a g e
APPLICANT S STATEMENT The infrmatin cntained in this applicatin is crrect t the best f my knwledge. I authrize any references r emplyers listed in this applicatin t give yu any infrmatin (including pinins) that they may have regarding my character and fitness fr children r yuth wrk. In cnsideratin f the receipt and evaluatin f this applicatin by Cahawba Christian Academy, I hereby release any individual, church, yuth rganizatin, charity, emplyer, reference, r any ther persn r rganizatin, including recrd custdians, bth cllectively and individually, frm any and all liability fr damages f whatever kind r nature which may at any time result t me, my heirs, r family, n accunt f cmpliance r any attempts t cmply, with this authrizatin, excepting nly the cmmunicatin f knwingly false infrmatin. I als understand that shuld CCA request a fingerprint and backgrund check, it will be my respnsibility t prvide withut reimbursement. I (check ne) waive d nt waive any right that I may have t inspect any infrmatin prvided abut me by any persn r rganizatin identify by me in this applicatin. Shuld I be hired by CCA, I agree t be bund by the plicies f Cahawba Christian Academy and t refrain frm unscriptural cnduct in the perfrmance f my services n behalf f the schl. I further state that I have carefully read the freging release and knw the cntents theref and I sign this release as my wn free act. This is a legally binding agreement which I have read and understand. Immediate terminatin may result as a cnsequence f prviding false infrmatin. Applicant s Signature Date Witness Date Cahawba Christian Academy des nt discriminate n the basis f any race, gender, natinal and ethic rigin as t the emplyment f persnnel. 5 P a g e
MISSION STATEMENT Cahawba Christian Academy prvides a Christ-centered envirnment thrugh Christian teachers and Christian curriculum. It is ur desire t challenge and inspire each student t glrify Gd by respnsible actins in ur mdern-day sciety. We prvide educatin frm a distinctive Biblical fundatin and perspective. The true reasn fr life and the study f every subject, as well as ur extracurricular events, are viewed in relatin t Gd and His Hly Wrd. ARTICLES OF FAITH We believe the Bible t be the inspired and nly infallible authritative Wrd f Gd. We believe that there is ne Gd, eternally existent in three persns: Father, Sn, and Hly Spirit. We believe in the deity f ur Lrd Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarius and atning death thrugh His shed bld, in His bdily resurrectin, in His ascensin t the right hand f the Father, and in His persnal return in pwer and glry. We believe that fr salvatin f the lst and sinful man, regeneratin by the Hly Spirit s indwelling that the believer is enabled t live a hly life and t be a witness fr the Lrd Jesus Christ and t wrk fr the Lrd Jesus Christ. We believe in the resurrectin f bth the saved and the lst: thse that are saved unt the resurrectin f life, and thse that are lst unt the resurrectin f damnatin. PERSONAL STATEMENT I subscribe withut reservatin t the Articles f Faith f Cahawba Christian Academy. I als understand that in regard t this emplyment applicatin, any misrepresentatin, missin, r misleading statement may result in terminatin f emplyment. I authrize Cahawba Christian Academy t cntact the references I have listed abve as well as my current r previus emplyer r pastr. Signature Date 6 P a g e
PERSONAL APPEARANCE At Cahawba Christian Academy, a high degree f self-respect, mdesty, neatness and prfessinalism is expected in all dress. Emplyees are expected t teach by example what an apprpriate Christian manner f dress is at all times. This will aid in gaining the respect yu deserve as prfessinals. The fllwing standards are effective fr all faculty, ffice staff, and media and technlgy emplyees. All ther emplyees shuld dress apprpriately fr the psitin they hld within the schl. These standards are in effect frm the beginning f faculty/staff rientatin thrugh the end f the schl year. Orientatin days and teacher wrkdays, rm preparatin and certain activities may require wrk attire. Emplyees shuld check with the Principal n such ccasins. Appearance standards fr summer emplyees are published by the ffice f the Principal. Any emplyee whse attire r dress is nt prfessinal in the pinin f the administratin shall be directed t cnfrm t this plicy. Emplyees wh are inapprpriately dressed, in the pinin f the administratin, may be sent hme and require t return t schl in acceptable attire. The emplyee shall nt be paid fr time away frm wrk. Apprpriate dress includes, but is nt limited t: Business suits/crdinated pants suits Cllared shirts with and withut ties Skirts (knee length) Dresses (knee length) Slacks Sweaters, bluses, knit tps, jackets Sweatshirts and t-shirts with schl-related insignia Clsed r pen te shes (n flip flps) Male emplyees shall keep beards and mustaches neatly grmed Attire in accrdance with envirnmental requirements fr specific jb assignments T ensure that emplyees are prfessinally attired, the fllwing are cnsidered unacceptable: Shrts (except fr physical educatin) Jeans, including veralls, f any clr (acceptable nly fr special days, activities, r related t specific jb assignments); n skinny pants f any kind Hats Immdest dress such as a dress that is t shrt (abve the knee) r tight r therwise revealing Slits in dresses r skirts abve the knee Oversized t-shirts and undershirts Leggings/Spandex Tank tps See-thrugh clthing Slippers/Flipflps Sundress withut a jacket 7 P a g e
Clthing that expses the midriff Sleeveless and/r extremely lw-cut dresses and bluses Exercise sweat suit Male emplyees shall nt wear earrings Jewelry r similar artifacts that are either bscene, distracting, r may cause disruptins t the educatinal envirnment Other attire as deemed inapprpriate by the administratin I understand, and I agree t abide by this dress plicy Signature Date BACKGROUND CHECK In accrdance with HB76, applicants must nw btain a criminal backgrund check thrugh 3M COGENT Inc. This is an nline applicatin prcess that will use live scans f fingerprints at certain lcatins. The cst f which will be $48.85 per applicatin. Fingerprint cards will n lnger acceptable. T submit yur applicatin, please visit the Gemalt website, click n Alabama, then the Department f Human Resurces, and fllw the Registratin prcess. 8 P a g e