Personal Data

Last Name    First Name   Middle Name
Previous Name     U.S. Citizenship Yes    No      Email Address

Current Address:                         Current Phone Number

Permanent Address:                                 Permanent Phone Number

For what position are you applying?  Please Check all that apply.:

Administration     List Position

Teaching/Administrative Experience 
 List dates, name of school, address, position, grade, or subjects taught and months of service.

Total education experience in years               Annual salary in most recent position $

Reason for leaving present or last position

Have you ever held a continuing contract in the state of Ohio Yes    No If so, where?

Have you ever been refused contract renewal? Yes    No       

If yes, please give explanation:

Certification/Licensure  List all Ohio certificates and licenses held:

Education  List high school and colleges attended, location, dates, grade point average, date of graduation, semester hours earned, and degree earned.  To reduce "quarter" hours to "semester" hours, multiply by 2/3. 

Other Employment Experience  List dates, employer, address, position, full or part-time.

References  List name, address and telephone of references; include superintendents and principals under whom you have taught.  

May we contact the above references? Yes   No

Military Service Record List dates, branch of service, length of service.

I certify the answers given herein are true and complete to the best of my knowledge.  I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.  In the event of employment, I understand that false or misleading information given in my application or interviews may result in discharge.  I also understand that I am required to abide by all policies, rules and regulations of the Board of Education and administration.  

Further, I authorize a complete criminal background check and I will allow my record (if any) to be disclosed to the Fort Recovery Local Board of Education.  

I hereby attest that I am not prevented from lawfully becoming employed in this country because of Visa or Immigration status.  (Proof of citizenship or immigration status will be required upon employment.)  

Do you accept the terms above? Yes  No                                                                  

Please note: No acknowledgement of this application will be forthcoming.  Unless reactivated  by written request this application will be destroyed two years from date of filing.  

********************************************************************************************************************

THIS SCHOOL DISTRICT IS AN EQUAL OPPORTUNITY EMPLOYER.  THANK YOU FOR YOUR TIME AND INTEREST IN MAKING APPLICATION TO THE FORT RECOVERY LOCAL BOARD OF EDUCATION.