Please Read This Sheet Carefully Before Completing the Professional Application

The following application can be completed electronically or manually. It can be submitted through mail, fax, or electronically. Please complete each section accurately as incomplete applications will not be considered.

The following information must be received in order to have a complete application packet on file for further consideration.

·  Professional Staff Application for Employment

·  A copy of your valid teaching certificate and/or a recent graduate letter of recommendation for certification

·  A copy of your transcripts

·  A current resume/vita (should include 3 personal references)

·  Non-Missouri Certified Applicants Only: Please contact Missouri DESE’s Educator Certification Department to help determine certification requirements at 573-751-0051 or visit their website at www.dese.mo.gov

Applications submitted from the previous year become inactive in January of the current year unless submitted on or after October 1st of the previous year.

If you opt to send your application electronically, please email it to the following address:

.

Caruthersville Public Schools 573.333.6100

1711 Ward Ave. (FAX) 573.333.6108

Caruthersville, MO 63830 www.cps18.org

CARUTHERSVILLE….dedicated to excellence!

Revised 12/15/05

Professional Staff Application for Employment For Office Use Only

Start Date
Location
Position
Category / Step

CARUTHERSVILLE PUBLIC SCHOOLS

1711 Ward Ave., Caruthersville, MO 63830

573.333.6100  (FAX) 573.333.6108

www.cps18.org

PERSONAL INFORMATION

Social Security No. / Date Available: / Date:
Name: (Last) / (First) / (Middle)
Present Address: / Permanent Address: (If different than present address)
Street: / Street:
City: / City:
State: / Zip: / State: / Zip:
Phone: / Phone:
Email address: / Cell phone:
Contact person: / Contact relation:
Contact’s phone:
POSITION(S) DESIRED

Early Childhood PreK-3:
Elementary 1-5 (Grade, Level):
Middle School 6-8 (Subject):
High School 9-12 (Subject):
Administration (Level):
What is your present position?
Are you under contract? / If so, what school district?
Reason(s) for desiring a change?
CERTIFICATION STATUS

SELECT ONE:

□ Pending □ MO Certified □ Other State □ None □ Will Apply Pending Graduation

In:

SELECT ONE:

□ Complete MO Certification □ Applied for MO Certification □ Out of State Complete Certification

□ Seeking Alternative Certification □ No Certification □ All certification exams not completed as of this date

□ Other (Please Explain):

DESCRIBE TEACHING CERTIFICATE(S)
Certification Area Grade Levels / Certificate Teaching Field(s) /
Date Issued
/ Expiration Date / State Issued

Other professional licenses or certifications:

If hired, can you furnish proof of employment eligibility in the U.S. under present immigration laws? □ Yes □ No

EDUCATIONAL EXPERIENCE– Copies of all transcripts and teaching certificates are required for application to be considered.

High School Name & Location
(City & State)
Undergraduate Education
College/University & Location / Dates / Major / Type of Degree / Hours in Ed. / Grad. Date
Graduate Education
College/University & Location / Dates / Hours Earned / Type of Degree / Major / Grad. Date
Block/Student Teaching
Location / Dates / Grade/Subject Taught / Supervising Teacher

EMPLOYMENT (List Teaching Experience only – Starting with most recent)

Name of School City & State / Dates

From To

/ Full Time / Part Time / Grade Levels/ Subjects Taught
Mo. / Yr. / Mo. / Yr.

TOTAL YEARS TEACHING EXPERIENCE______

HAVE YOU EVER BEEN DISCHARGED FROM ANY EMPLOYMENT, HAD A CONTRACT OF EMPLOYMENT NON-RENEWED, BEEN ASKED TO RESIGN FROM YOUR EMPLOYMENT OR RESIGNED FROM EMPLOYMENT IN LIEU OF DISCHARGE OR NON-RENEWAL? ______Yes ______No

If yes, provide a full description of the circumstances of the discharge, non-renewal, or resignation.

Have you ever entered a plea of guilty or been found guilty of a crime other than a traffic violation? (Note: This includes a suspended imposition of sentence.) ______Yes ______No

If “yes”, please complete the following:

Name of Offense / Date / Place of plea and/or conviction

EXTRA CURRICULAR ACTIVITIES & INTERESTS

Activity/Sport / Location / Years Exp. / Sponsor/ Coach / Participant / Willingness to Coach/Sponsor

EDUCATIONAL PHILOSOPHY (Please briefly answer the following questions.)

1. What do you see is the most important role of a teacher/administrator? (Choose the appropriate position for
your application)
2. In your opinion, what is the most effective means of improving student performance?
3. List 3 goals that you hope to accomplish during the first year of employment with the district.
4. Describe 1 research-based strategy that you feel is effective in your role as a teacher/administrator.

ON A SCALE OF 1-10 PLEASE RATE YOUR LEVEL OF EXPERTISE IN THE FIELD OF TECHNOLOGY. (One being the least knowledgeable and ten being the highest level of expertise)

AUTHORIZATION

I authorize Caruthersville Public Schools to investigate the statements contained herein. I certify that my
statements on this application are true and that falsification of this application is cause for dismissal or
rejection of employment. I also understand that an electronic signature is a valid commitment to the
authorization and to the application statements and information.

Signature Date

PLEASE NOTE

Requirements of Employment: If you are offered a contract, it will be under the conditions that complete official transcript(s) and a Missouri teacher’s certificate will be submitted before employment begins. Verification of prior certified PreK-12 teaching experience will be required to place teachers on the salary schedule above the base range.

Caruthersville Public Schools does not discriminate in admission or access to program activities or employment on the basis of race, gender or handicap. The Compliance Coordinator for Title IX and Section 504 is the Assistant Superintendent.