An Equal Opportunity Employer OYMENT APPLICATION FOR SUBSTITUTE TEACHER
We consider applicants for all positions without regard to
race, color, national origin, age, religion, sex, marital status, veteran or
military status, disability, or any other legally protected status.
Date of application _________________ Social Security Number_____________________
Name______________________________________________________________________________
Last First Middle
Mailing address
_____________________________________________________________________
Street/Box
City State ZIP
Code
Other address where you may be reached
_________________________________________________
Work phone _________________________ Home phone_______________________
Other name that may appear on
records_________________________________________
Used for
certification, reference, and criminal history record checks)
Have you been employed by Holland ISD in the past? _____Yes
_____No
If you answered yes, provide dates of
employment__________________________________________
Education
Check the highest level of education attained:
_____High school graduate ______GED
_____Less than two years of college ______Two or more years of college
_____Bachelor’s degree ______Master’s degree
Other training or education:
_____________________________________________________________
____________________________________________________________________________________
EMPLOYMENT APPLICATION FOR SUBSTITUTE TEACHER
Certification
List any certifications/license
held: ________________________________________________________________________________________________________________________________________________________________________
Work Experience
List work experience beginning with most recent years.
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Name &
location of company |
Type of
assignment |
Dates Employed |
Reason for
leaving |
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EMPLOYMENT APPLICATION FOR SUBSTITUTE TEACHER
Availability:
Please list the days you are available to substitute.
Day(s) of week: o Every day
o Only the
following: oMonday oTuesday oWednesday oThursday oFriday
Comments:
____________________________________________________________________________
Are you receiving Texas Teacher Retirement (TRS) benefits? oYes oNo
(The amount of time that an individual
receiving TRS benefits may be employed without affecting benefits is governed
by TRS rules and laws.)
General Information
Have you ever been convicted of, plead guilty or no contest
(nolo contendre) to, or received probation, suspension, or deferred
adjudication for a felony or any offense involving moral turpitude (including,
but not limited to, theft, rape, murder, swindling, and indecency with a
minor)? oYes oNo
If yes, please state where, when, and the nature of the
offense__________________________________
____________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________
(A
felony conviction is not an automatic bar to employment. The district will
consider the nature, date, and relationship between the offense and the
position for which you are applying.)
References:
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Reference full
name |
Company Name |
Mailing address
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Area code & phone number |
Position/title |
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EMPLOYMENT APPLICATION FOR SUBSTITUTE TEACHER
Verification:
I hereby affirm that all information provided in this
application is true and accurate to the best of my knowledge and understand
that any deliberate falsifications, misrepresentations, or omissions of fact
may be grounds for rejection of my application or dismissal from subsequent
employment. I authorize the references
listed on the previous page to give you any and all information concerning my
previous employment and any pertinent information they may have, personal or
otherwise, and release all such parties from liability for any damage that may
result from furnishing the same to you.
I understand that the district is authorized by Texas Education Code
§22.083 to obtain criminal history record information on applicants the
district intends to employ.
__________________________________ ______________
Signature
Date
This application becomes the property of the district. The
district reserves the right to accept or reject it.