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EMPLOYMENT APPLICATION R EGENTS SCHOOL OF CHARLOTTESVILLE 200 Bob Finley Way Charlottesville, VA 22903 434-293-0633 www.regents-school.org Your interest in Regents School is appreciated, and we look forward to receiving your application soon. If it appears that you may be qualified for one of our openings, a personal interview will be arranged. Date of Application: Desired Position: PERSONAL INFORMATION Applicant Name: Home Phone: Cell Phone: Place of Birth: Date of Birth: Email: _ Church Church Pastor: Pastor Phone: Please list any organizations in which you actively participate: BACKGROUND Are you a citizen of the United States? yes no Are you legally eligible to work in the United States? yes no In compliance with the Immigration and Reform and Control Act of 1986, you will be required to verify and document your employment eligibility if hired. Have you ever been convicted of a crime? yes no If yes, please explain: Have you ever been dismissed for misconduct or unsatisfactory performance or been forced to resign from a job?

Do you have any recurring illnesses or other difficulties that may, at any time, affect your teaching ability? yes no If yes, please explain: EDUCATION Use additional paper if needed. College/University: Major: Minor: Degree: College/University: _ Major: Minor: Degree: TEACHING EXPERIENCE Use additional paper if needed. School: Grades/Subjects: School: Grades/Subjects:

CREDENTIALS Do you have a state-issued teaching certificate? yes no If so, what is it for and from which state? Is it currently valid? yes no Expiration Date: Do you have any other teaching credentials? If so, please describe them and the issuing authority: What grade would you prefer to teach? List other grades and/or specialized subjects you believe you are qualified to teach in order of preference: Please describe any non-teaching experiences or training you have had that you believe would enhance your ability to teach at Regents School: OTHER WORK EXPERIENCE Use additional paper if needed. Job Title: Employer: Supervisor: Supervisor Phone: Job Title: Employer: Supervisor: Supervisor Phone:

PROFESSIONAL DEVELOPMENT & INTERESTS Please limit answers to no more than 500 words. Use additional paper if needed. Please list your hobbies and interests: Are you interested, gifted, or talented in any of the following areas? art drama/theatre music (vocals) instrument(s): coaching/sport(s): foreign language(s): Approximately how many hours do you spend reading for pleasure each week? Please list five books you have read in the past year for pleasure: What trends do you see in your reading over the past five years? Have you had any military or travel experiences? If so, please provide a brief description: Have you had any other experience with or exposure to classical Christian education? (e.g. Were you classically educated? Have you attended a classical Christian conference or seminar?) Do you feel called to teach? Explain:

Express your thoughts on classroom order and discipline: Where do you hope/plan to be in five years? What are your strengths and weaknesses? CHRISTIAN BACKGROUND AND TRAINING Please be prepared to address the following items during an interview: 1. A brief description of how you came to Christ (including date of salvation) and your spiritual journey since then. 2. The authority the scriptures have in the world and in your life. 3. A brief discussion of any formal training in the scriptures that you have received. 4. The unique function of a Christian school. 5. Your reasons for seeking a position in a Christian school. STATEMENT OF FAITH The Statement of Faith forms the foundation of beliefs upon which Regents was established. The substance of these statements is considered primary doctrine of Regents. 1. We believe the Bible alone to be the word of God, the ultimate and infallible authority for faith and practice. 2. We believe that there is one God, eternally existent in three persons: Father, Son, and Holy Spirit. He is omnipotent, omniscient, and omnipresent.

3. 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. 4. We believe that, for the salvation of lost and sinful men, regeneration by the Holy Spirit is absolutely necessary. 5. We believe that salvation is by grace through faith alone. 6. We believe that faith without works is dead. 7. We believe in the present ministry of the Holy Spirit, by whose indwelling the Christian is enabled to live a godly life. 8. We believe in the resurrection of both the saved and the lost; they that are saved to the resurrection of eternal life and they that are lost to eternal damnation. 9. We believe in the spiritual unity of all believers in our Lord Jesus Christ. I believe in and assent to the above Statement of Faith, and, if employed by Regents School, I will faithfully teach all courses based on the Statement of Faith as the foundation of all true learning. Applicant s Signature Date REFERENCES Please give the names of individuals who can attest to your character and teaching abilities. Include a pastor, principal (if prior teaching experience), a supervisor from a previous non-teaching job (if applicable), and a personal reference. Be sure that at least one of these references was a direct supervisor overseeing your work in whatever capacity. PASTOR PRINCIPAL SUPERVISOR PERSONAL

Relationship: I warrant that the representations made herein are true. Applicant s Signature Date Regents School does not discriminate on the basis of race, color, national, or ethnic origin in the administration of its educational, admission, financial aid, or employment policies, or any other programs administered by the school. OFFICE USE ONLY Application Received Transcripts Received References Checked Interview Scheduled