Today’s Date_________

Paris Union School District No. 95

300 South Eads Avenue Paris, IL 61944

www.paris95.k12.il.us

(217) 465-8448

Application for Employment

Position Desired________________________________

GENERAL INFORMATION

Name____________________________________________________________________________________

Present Address____________________________________________________________________________

Telephone Number ( ) ( ) .

Day Evening e-mail

Soc. Sec. #________________________________Citizen of U.S.A._____________Date Available: ________

Have you ever been arrested, charged, pled guilty, or convicted of a felony, sex-related offense, act of violence, misdemeanor, or any offense other than a minor traffic violation? You are not obligated to disclose sealed or expunged records of a conviction or an arrest. _____

Has your professional license ever been revoked? _____

Have you ever been discharged or separated from a position with a school district or been asked to resign a licensed arrangement? _____

Have you ever been the subject of an investigation by a school district or any other employer? _____

Have you ever had sanctions placed on your teaching certificate for any reason? _____

Have you ever been denied a teaching certificate anywhere? _____

Is disciplinary action currently pending against your certificate? _____

PROFESSIONAL EXPERIENCE

List most recent first.

M/y to m/y school district city/state grades/subjects annual salary

CERTIFICATE INFORMATION

Area(s) of certification – Teaching _______________________________ Degree __________________

Administrative ___________________________ Degree __________________

STUDENT TEACHING

M/y to m/y school city/state grade/subject

EDUCATION

M/y to m/y school city/state major/program degree/diploma

OTHER WORK EXPERIENCE

(business, trades, summer positions, social services, etc.)

m/y to m/y firm/institution, etc. nature of work # of months

ESSAY

In the space below, please discuss the following topic:

Your philosophy of education, and how, as a teacher, you will put this philosophy into action. You may wish to include additional information regarding your candidacy, for instance, references to your membership in professional organizations, participation in community or professional activities, and your interest in Paris Union School District No. 95. Your signature below attests to the fact that the essay is your own work. (Use other page, if needed.)

Return the essay with your completed application.

______________________________________ ___________________________________

Applicant’s Signature Today’s Date

REFERENCES

Give the names and addresses of those who have closely observed your work as a teacher. Please send original letters of reference or placement folder. Your signature below is your permission to contact references.

Full name Title/position

Street City State Zip Telephone

Full name Title/position

Street City State Zip Telephone

Full name Title/position

Street City State Zip Telephone

Applicant’s Signature Date

MUST BE READ BY ALL APPLICANTS

I certify that the information contained in this application is true and correct to the best of my knowledge, and I understand that false or incorrect information in this application is grounds for disqualification from further consideration or for subsequent dismissal from employment if I am hired. I also agree to notify Paris Union School District No. 95 of any material changes in the information provided on this application. I hereby consent to have Paris Union School District No. 95 contact anyone it deems appropriate to investigate or verify any information I have given or to discuss my background, past performance, or suitability for employment. Further, I hereby authorize my former employer(s), reference(s), and any other individual or organization to provide information solicited by Paris Union School District No. 95, and I hereby release and discharge each of the above, including Paris Union School District No. 95 from any liability of any kind or nature and waive all rights to bring any action for defamation, invasion of privacy, or any similar cause of action against anyone contacted as a result of what he or she may say about me.

Applicant’s signature Date

An Affirmative Action and Equal Opportunity Employer

Paris Union School District No. 95 does not discriminate in hiring on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or status in any other protested group. No questions on this application are intended to be used for such discrimination.