EASTON SCHOOL DEPARTMENT

PO BOX 126

EASTON, ME 04740

PHONE (207) 488-7700 FAX (207) 488-2840

APPLICATION FOR TEACHING POSITION

The Easton School Department does not discriminate in the operation of its educational and employment policies and will honor all appropriate laws relative to discrimination.

Date:_________________________ Position(s) applying for: (Grade level, subject, other)

Name:_________________________ _________________________________________

_________________________________________

When will you be available? _________ _________________________________________

Permanent Address: ______________________________________________________________________________

Temporary Address: ______________________________________________________________________________

EDUCATION: Transcripts, including grades, from all college(s)/university(s) attended must be provided. It is essential that this section be completed accurately.

No. of Years Grade Point

College/University Attended Degree Awarded (if any) Attended Average

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Number of semester hours in:

___________Reading _________Major(Subject:_________________)

___________Math _________Minor(Subject:_________________)

___________Special Education _________Major(Subject:_________________)

_________Minor(Subject:_________________)

CERTIFICATION: List certification(s) you hold and provide copies of certification.

Type State Date Issued Date of Expiration

______________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________

If you do not hold a Maine certificate, for what type of Maine certificate are you applying and eligible? _____________________________________________________________________________________

______________________________________________________________________________

NOTE: Candidates who do not hold Maine certification should direct an inquiry to the Maine Department of Education, Division of Certification and Placement, Augusta, Maine 04333.

EXPERIENCE: A resume must be provided. In addition to educational background and work experience, include extracurricular activities in which you have been involved. Please list below positions held, employer and dates of employment for the past ten years. Please account for any gaps in employment on a separate page.

From (month/year) To (month/year) Position Employer

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Number of years of teaching experience ________. On a separate sheet, please describe a specific class or class activity you planned and actually conducted which illustrates your philosophy of teaching and is the best example of your teaching skill. What evidence showed you that this class or activity was successful in terms of student motivation and achievement?

BACKGROUND:

Have you ever been disciplined, discharged, or asked to resign from a prior position? Yes ___ No ___

Have you ever resigned from a prior position after a complaint had been received against

you or your conduct was under investigation or review? Yes ___ No ___

Has your contract in a prior position ever been non-renewed? Yes ___ No ___

Have you ever not been nominated for re-employment in a prior position or ever had your

nomination for re-employment not be approved? Yes ___ No ___

Have you ever been charged with or investigated for sexual abuse or harassment of another

person? Yes ___ No ___

Have you ever been convicted of a crime (other than a minor traffic offense)? Yes ___ No ___

Have you ever entered a plea of guilty or “no contest” (nolo contendere) to any crime (other

than a minor traffic offense)? Yes ___ No ___

Have you ever had a professional license or certificate suspended or revoked in any state,

or have you ever voluntarily surrendered, temporarily or permanently, a professional license

or certificate in any state? Yes ___ No ___

Has any court ever deferred, filed or dismissed proceedings without a finding of guilty and

required that you pay a fine, penalty or court costs and/or imposed a requirement as to your

behavior or conduct for a period of time in connection with any crime (other than a minor

traffic offense)? Yes ___ No ___

If you have answered YES to any of the previous questions, provide full details on an additional sheet including, with respect to court actions, the date, offense in question, and the address of the court involved. Conviction or other disposition of a crime is not necessarily an automatic bar to employment.

REFERENCES: List three, two of whom are most recent supervisors, who can comment on your ability and whom we may contact. In addition, please provide three letters of reference from persons who are not related to you (may be from references listed below).

Name Position Address Phone

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

My signature below constitutes authorization to check my employment history, including without limitation, criminal arrest and conviction record checks, reference checks, and release of investigatory information possessed by any state, local or federal agency. I further authorize those persons, agencies or entities that the Easton School Department contacts in connection with my employment application to fully provide the Easton School Department any information on the matters set forth above. I expressly waive in connection with any request for or provisions of such information, any claims, including without limitation, defamation, emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against the Easton School Department, its agents and officials or against any provider of such information.

I understand that information submitted in and with this application may be disclosed to a screening and/or interviewing committee, which may include board members, administrators, other staff, and members of the community. I give my consent to this disclosure.

__________________________________________

Signature Date

APPLICATION FOR TEACHING POSITION CHECKLIST: The completed employment application cannot be evaluated unless all of the following materials have been provided:

_____ Application from fully completed

_____ Copies of Transcript(s)

_____ Copy of Maine Certification(s)

_____ Resume

_____ Gaps in employment during past ten years explained

_____ Illustration of your philosophy of teaching

_____ YES to any of the questions in the Background section explained

_____ Three letters of reference

_____ Application signed

NOTE: ALL APPLICATION MATERIALS BECOME THE PROPERTY OF THE EASTON SCHOOL DEPARTMENT. NONE WILL BE RETURNED. PROVIDING ANY FALSE OR MISLEADING INFORMATION ON THIS APPLICATION OR IN THE APPLICATION OR EMPLOYMENT SCREENING PROCESS SHALL BE FULLY SUFICIENT GROUNDS TO REFUSE TO EMPLOY THE APPLICANT OR, IF THE APPLICANT HAS BEEN EMPLOYED, TO IMMEDIATELY DISMISS THE APPLICANT/EMPLOYEE.

NOTE: EMPLOYMENT CANNOT BE FINALIZED UNTIL THE APPLICANT HAS COMPLETED REQUIREMENTS FOR COMPLETE BACKGROUND CHECKS AND FINGERPRINTING AS REQUIRED BY MAINE STATE STATUTE.