Shattuck Public Schools

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Employment Application - Certified

CERTIFIED STAFF
APPLICATION FOR INSTRUCTIONAL STAFF POSITION

All applicants for teaching, counseling or administration positions at Shattuck Public Schools must complete this application. If selected, candidate must provide complete transcripts and a photocopy of an Oklahoma Certification.

Please Fill Out The Employment Application - Certified Below

Name

Social Security Number

Mailing Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Home Phone Number

Cell Phone Number

Position Applied For

Elementary Grades PreK-4

Middle School Grades 5-8

High School Grades 9-12

Counselor

Library Media

Special Education

Administrator

Other

Subject(s) Area if applicable:

Certification #

Expiration Date

List Area(s) of Certification

Organizational Memberships

Honors Earned

References: List the name of four references capable of giving information about your teaching and preparation for teaching. List at least one administrator for each of your teaching positions.

1. Full Name of Reference

Position

School Name and Address

Phone

2. Full Name of Reference

Position

School Name and Address

Phone

3. Full Name of Reference

Position

School Name and Address

Phone

4. Full Name of Reference

Position

School Name and Address

Phone

Education

High School Attended

Mailing Address

Year Graduated

College or University Attended

Dates of Attendance

Major Field of Study

Minor Field of Study

Degree

Doctorate

Ed. Specialist

Masters

Bachelors

Associate

Other

Year Earned

Experience

1. Position/Job

Location

Duties

Dates

Principal or Supervisor

2. Position/Job

Location

Duties

Dates

Principal or Supervisor

3. Position/Job

Location

Duties

Dates

Principal or Supervisor

4. Position/Job

Location

Duties

Dates

Principal or Supervisor

Provide additional information about yourself which would assist administrators as they evaluate your application.

Extra Curricular Activities You Can Assist With

Yearbook

Robotics

Cheerleading

Coaching

Other

Are you willing to accept any assignment for the good of the school system, attend meetings or participate in other activities outside of school hours or Saturday mornings?

Have you ever failed to be reemployed?

Where?

If yes, please explain

Why do you wish to leave your current position?

On what date will you be available if offered employment?

Have you ever had a certificate revoked or suspended?

Have you ever surrendered a certificate before its expiration?

Have you ever resigned a position as part of an agreement to avoid certificate revocation?

Have you ever been released or have you ever resigned from school-related employment because of misconduct or unsatisfactory service?

Have you ever resigned a school-related position as part of an agreement to avoid dismissal?

Email a copy to

optional

Required Fields