Check One: New Applicant Applied Previously Former Employee Present Staff Member Date of Application: Last Name: First Name: Middle Name: Maiden Name: Social Security: Street Address: City, State Zip: Telephone #: E-Mail Address: Verity E-Mail: Religion: United States Citizen? Yes No If you are not a citizen of the United States please mail details of your eligibility for employment in the U.S. Have you ever been convicted of violating any law (except minor traffic violations)? Yes No If "yes", separately mail a listing of all convictions showing offense, where convicted, and date of conviction. Disclosure of a criminal record may not automatically disqualify you from employment consideration. Have you ever had a teaching certificate revoked or suspended for any reason? Yes No If "yes", please mail an explanation. As defined under the American's with Disabilities Act, do you require any "reasonable accommodation" in order to perform the job for which you have applied? Yes No Grade Preference: K 1 2 3 4 5 6 7 8 9 10 11 12 Assignment Preference: Full Time Part Time Substitute Subject Preference: Can you coach athletics, direct music ordramatics, sponsor clubs or participate in any other activities? Please specify.: CERTIFICATION(Also indicate certificates for which you will become eligible) Code FromCertificate Rank Date Effective Expiration Date CertificateDescription Diocesan Religious Certification Diocese: Type: EDUCATION University Degree or SemesterHours Completed Year(s) Attended Major/Minor PREVIOUS EDUCATIONAL EXPERIENCE Year(s) Taught School Address Subject(s)/Grade(s) Taught Please respond to the questions below briefly and candidly.Your response will help to better understand the strengths youcan bring to the teaching profession in general and to oursystem in particular. 1. What do you want to accomplish as a teacher? 2. How will (do) you go about finding out students' attitudes and feelings about your class? 3. An experienced teacher offers you the following advice: When you are teaching, be sure to command the respect of your students immediately and all will go well. How do you feel about this? 4. How do you go about deciding what it is that should be taught in your class? 5. A parent comes to you and complains that what you are teaching his child is irrelevant to the child's needs. How would you respond? 6. What do you think will (does) provide you with the greatest pleasure in teaching? 7. When you have some free time, what do you enjoy doing the most? 8. How do you go about finding what students are good at? 9. Would you rather try a lot of new teaching strategies or would you rather try to prefect the approaches which work best for you? Explain your views. 10. Do you like to teach with an overall plan in mind for the year, or would you rather just teach some interesting things that let the process determine results? Explain your position. 11. A student is doing poorly in your class.You talk to her and she tells you that she considers you to be the poorest teacher she has ever met. What would you do? 12. If there were absolutely no restrictions placed upon you, what would you want to do in life? Date that you can begin teaching: Additional Comments:
Please respond to the questions below briefly and candidly.Your response will help to better understand the strengths youcan bring to the teaching profession in general and to oursystem in particular.
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