Application for Certified Teaching Position

Marshall Public School District

860 W. Vest

Marshall, MO   65340

(660)886-7414

 

We afford equal opportunity to qualified individuals regardless of their age, race, color, national origin, ancestry, religion, socio-economic status, marital status, sex, handicaps or memberships in legally constituted organizations to the extent required by all applicable laws.

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POSITION DESIRED

 

 Early Childhood                                      Grade:      

 Elementary School (K-4)                                           

 Middle School (5-8)                     Subject Area:      

 High School (9-12)

 Vocational/Career Center (9-12)

 Special Education

 Other Teaching Position

PERSONAL INFORMATION

Name:      

Date of Application:

     

Present Address:     

 

Telephone Number(s)     

Social Security Number (Optional)

     

Permanent Address (if not same as above)     

 

Permanent Telephone Numbers (if not same as above)     

 

E-mail Address (Optional):     

 

 

Are you a United States citizen or able to work legally in this country?       Yes  No

Have you ever been convicted of a crime?                                               Yes  No

Are you presently under contract with any school district for next year?    Yes  No

 

Present Position      

 

Are you willing to accept after-school responsibilities?      Yes  No

 

What activities do you feel qualified to sponsor/coach?         

 

Date available for employment      

 

Missouri Retirement System Number: ______________________________________________________

NOTE:  Mark X in the blank if you have never belonged to the System or if your contribution has been withdrawn.

 

Certification Area

Grade Levels

Life or Date Certification Expires

     

 

     

     

     

 

     

     

     

 

     

     

     

 

     

     

     

 

     

     

 

EDUCATIONAL BACKGROUND

Name/Location

Dates Attended

Graduation Date

Degree

Credit Hours Earned

     

 

     

     

     

     

     

 

     

     

     

     

     

 

     

     

     

     

     

 

     

     

     

     

     

 

     

     

     

     

PROFESSIONAL BACKGROUND (Teaching/Administrative Experience)

NOTE:  Begin with most recent

Name/Location

Assignment

Years Completed

Supervisor/Phone No.

Reason for Leaving

     

 

     

     

     

     

     

 

     

     

     

     

     

 

     

     

     

     

     

 

     

     

     

     

     

 

     

     

     

     

WORK EXPERIENCE (Other than Teaching)

NOTE:  Begin with most recent

Name/Location

Period of Service

Type of Work

Reason for Leaving