ADMINISTRATIVE POSITION APPLICATION

FOR BAKER SCHOOL DISTRICT 5J

2090 Fourth Street

Baker City OR 97814

(541) 524-2261

FAX (541) 524-2564

The Baker 5J schools exist to be the center of community vitality eliminating the barriers for gratifying individual educational experiences in order to have capable contributing citizens with character.

MAILING INSTRUCTIONS
Completed application form with letter of application,
resume, two letters of recommendation, administrative license,
unofficial transcripts, and any supporting materials
should be mailed to:
Norma Nemec
Personnel
Baker School District 5J
2090 Fourth Street
Baker City, Oregon 97814
  1. Please complete and sign the application and forward it with your letter of application, resume, and two letters of recommendation to the address printed in the box above. Complete the application form in full.
  1. In your letter of application, please give your reasons for wanting to work in our district and address your willingness to live in our community.
  1. Please submit a copy of your college or university transcript (unofficial).
  1. Please submit a copy of your administrative license or proof of qualifications to obtain certification.
  1. You must answer all of the questions asked in this document.
  1. Applicants are asked not to contact members of the school board. You will be notified when

arrangements for interviews have been completed.

NAME ______SSN ______

LAST FIRST MIDDLE

1. PERSONAL INFORMATION

______

Present Position

______

Business PhoneHome PhoneE-Mail Address

______

Business AddressHome Address

City, State, ZipCity, State, Zip

Type of Organization or School Unit and Grade LevelEnrollment

Certificates Presently HeldIssue Date Expiration Date

OEligible for CertificationDate:______Certificate:______

2. EMPLOYMENT HISTORY

Please complete this form by listing all full time experiences both within and outside the field of education. List your most recent employment first. Attach additional information as necessary.

Date
From B To / Years / Position/Place / Specific Duties

3. PROFESSIONAL PREPARATION

Institution and Location / Major/Minor / Degree / Date
Undergraduate
Graduate
Other

4. MEMBERSHIPS AND AFFILIATIONS, PUBLICATIONS, TRAVEL, ETC.

5. REFERENCES

Please list the names of four or more persons who know of your professional work and qualifications. Include at least one reference from your presentemployer, a colleague, and a non-educator.

Name

/

Position

/

Present Address

/
Telephone
Office Home

·Have you ever been convicted of a crime?O YESO NO (Do not include minor traffic violations for which a fine of $50 or less was imposed. )

·Have you ever had a teaching and/or administration license investigated or revoked in Oregon or another state? OYES O NO

If any answer to the above questions is YES, please provide complete details on a separate sheet of paper.

Equal employment opportunity and treatment shall be provided in hiring, retention, transfer, promotion and training of all employees regardless of age, handicap, national origin, race, religion, or sex.

6. QUESTIONS

Directions:In order to complete the application, you must answer each of the questions in the space provided. DO NOT USE ADDITIONAL PAGES. Each answer should reflect your knowledge, insight, feelings, or point of view. Please be clear and concise.

1.What are the latest strategies to differentiate instruction in the classrooms?

2.What is the purpose of staff evaluation? Describe what you know about the Charlotte Danielson evaluation model.

3.How would you assume the role of instructional, curriculum, and assessment leader, especially utilizing site-based decision making and/or collaboration?

4.Describe the values that you believe make an effective leader and how they relate to your leadership style.

The Superintendent and Screening Committee in Baker City, Oregon have my permission to examine all records and letters related to my application, and to contact the persons whom I have identified as references, my present and previous employers, and to conduct a criminal history check. I understand that any misrepresentation, falsification, or omission will be sufficient cause for cancellation of the application or discharge if I have been employed.

The information listed herein is an accurate summary of my personal record to-date.

______

Signature of ApplicantDate

2/23/16