Certified Job Application

Certified Employment Application

Personal Information

Position Applying For *

First Name *

Middle Name

Last Name *

Address *

City

State

Zip Code

Phone *

Email *

Have you ever been arrested or charged with a felony or misdemeanor?

Have you ever been involuntarily terminated, resigned in lieu of termination, or contract not renewed?

Race

Gender

Veteran Status

Ethnicity

Date of Birth *

Education

High School

Name

City

Graduation Year

College

Name of College/University Attended

Degree Awarded (if any)

#Credits Earned

Certification Information

Educator's Area(s) ofCertification

State

Other Area(s) of Certification

Work Experience

Name of Present or Last Employer

Job Title or Position Held

Dates of Employment

Supervisor Name

Supervisor Email

Supervisor Phone

Salary

May we contact this employer?

Reason For Leaving

Name of Employer

Job Title or Position Held

Dates of Employment

Supervisor Name

Supervisor Email

Supervisor Phone

Salary

May we contact this employer?

Reason For Leaving

Name of Employer

Job Title or Position Held

Dates of Employment

Supervisor Name

Supervisor Email

Supervisor Phone

Salary

May we contact this employer?

Reason For Leaving

Professional References

Documents

Resume Upload

Transcript

Certifications

Praxis Scores

Signature

The Lawrence County School District is an equal opportunity employer. The School District does not discriminate on the basis of race, color, national origin, age, sex or disability, in admission or access to, or treatment or employment in its programs and activities.

I hereby certify that the statements above are true and complete to the best of my knowledge and authorize investigation of all statement here recorded. I release from all liability persons and organizations reporting information required by this application. I understand that any false statements or omissions may be grounds for dismissal.

Date

All information will be kept confidential. Attach proper documents as requested. The Lawrence County School District is an equal opportunity employer.