Summit School, Inc.
333 West River Road / Elgin, IL / 60123 / 847-468-0490
Job Application - Teacher
Name:
Date:
Address:
City:
State:
Zip:
Phone:
Alt. Phone:
EDUCATION
High School:
School:
Dates Attended:
Diploma/Degree:
School:
Dates Attended:
Diploma/Degree:
Undergraduate:
School:
Dates Attended:
Diploma/Degree:
School:
Dates Attended:
Diploma/Degree:
Graduate:
School:
Dates Attended:
Diploma/Degree:
School:
Dates Attended:
Diploma/Degree:
Additional Training: (i.e., pertinent workshops, seminars or other experiences):
List specifically all Special Education or Early Childhood courses:
CURRENT EMPLOYER (include how long you have been employeed there)
EMPLOYMENT EXPERIENCE
Place:
Years:
Dates Worked:
Place:
Years:
Dates Worked:
Place:
Years:
Dates Worked:
Experience in other any areas :
Failure to provide requested employment or employer history which is material to the applicant’s qualifications for employment or the provision of statements which the applicant does not believe to be true may be a Class A misdemeanor.
REFERENCES (including present employer) Please include phone numbers:
1:
2:
3:
4:
MEMBERSHIP IN PROFESSIONAL ORGANIZATION:
TYPE OF CERTIFICATION
Certification Number:
AGE LEVEL YOU ARE QUALIFIED TO TEACH
Preschool:
Primary:
Junior High:
Intermediate:
High School:
JOB SPECIFIC INQUIRIES:
Do you have a valid Illinois driver’s license?
Yes
No
Has your driver’s license ever been suspended, terminated or revoked?
Yes
No
Has your teaching license ever been suspended, terminated or revoked?
Yes
No
HAVE YOU BEEN CONVICTED OF A FELONY WITHIN THE LAST 5 YEARS?
Yes
No
Record of conviction does not disqualify applicant from employment consideration.
If you answered yes to the any of the above please explain:
SALARY:
Present Salary:
Expected Salary:
In a brief paragraph, state why you feel you should be considered for a position at Summit School Inc. You may include your educational philosophy and specific skills you have to teach students.
By submitting this application, you are confirming that you have read the following statement.
The information provided in this Application for Employment is true, correct and complete. If employed, any misstatement or omission of act on this application or any interview may result in my dismissal. I understand that this employment application and other documents are not contracts of employment. I authorize Summit School Inc. to thoroughly investigate my references, personal history, work record and matters related to my suitability for employment. I also release Summit School Inc. from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. I understand and agree that if I am employed, I will be asked to sign a Contract stating terms of my employment.
Please note that this application is considered current for six months. If you want to be considered for employment after this time, you must complete another application form.
© Copyright 2006-2011 Summit School Incorporated
