City, State, Zip
Have you aqcuired tenure in Pennsylvania?
If yes, in what School District?
Date available for employment
Most recent employer: Currently Employed?
May we contact your current employer?
Dates of Employment (month/year) From
Reason employment ended
Please attach photocopies of letters of reference and/or evaluations from college/university student teacher supervisor and cooperating teacher(s).
References should include superintendents, principals, or professors who have first-hand knowledge of your professional competence and your personal qualifications. Experienced teachers should include the superintendent and principal of the two most recent schools in which emploted. If any person(s) listed should not be contacted for reference at the present time, indicate the date contact(s) may be made.
I certify that all information I have provided on this application is complete and true to the best of my knowledge and belief, and are made in good faith. I understand that any false statements contained herein can be considered grounds for rejection or dismissal, once hired.
I authorize any and all of my previous employers and/or supervisors to release any and all of my personnel records, and to respond fully and completely to all questions that officials of Frederick Douglass Christian School may ask regarding my prior work history and performance. I will hold such pervious employers and/or supervisors harmless of any and all claims that I might otherwise have against them with regard to statements made to this school district. I further authorize these officials to investigate my background. However, I do not authorize inquires which would tend to actually identify a disability nor do I authorize inquiries which would include information related to any medical condition or medical history. Further, I do not waive any rights which I may have under state or federal law related to my right to challenge the disclosure of unlawful or inaccurate information, whether by the school district, including any and all claims concerning allegations of employment discrimination because of race, color, sex, religion, national origin, ancestry, age, or disability.
Thanks for submitting!