Revised August, 2016

DATE:

NAME: ______

PLEASE CHECK:
_____ Instructional
_____ Administrative
_____ Substitute

(Last) (First) (Middle/Maiden)

POSITIONS PREFERRED:In order of preference, list position, grade level(s), and subject in which you are or will be certified in the State of Mississippi.
1. ______
2. ______
3. ______

SOCIAL SECURITY NUMBER: ______

PRESENT ADDRESS: ______

______

(City)(State) (Zip Code)

PERMANENT ADDRESS: ______

______

(City)(State) (Zip Code)

TELEPHONE: ______

(Area Code) (Phone Number)

SCHOOLS / NAME AND ADDRESS OF INSTITUTIONS / DATES ATTENDED / DEGREE / G.P.A. / AREA OF SPECIALIZATION
High School
College
Graduate
Post Graduate

Mississippi Certificate # ______Class ______Type ______Exp. Date ______

Areas of Current Endorsement(A) ______(B) ______

Subjects with 18 or more hours(A) ______(B) ______

Praxis Exam Score: ______Subject Area Score: ______Common/Core Battery Score ______

List the names of four employment references, including principals (present and/or last), supervisors, and superintendents. Beginning teachers must have a reference from the directing teacher and principal of school where internship was completed as well as from the college supervisor of student teaching. Please give correct addresses which are legible and complete.

NAME / ADDRESS / POSITION / TELEPHONE
“It is the policy of the Lauderdale County School District not to discriminate on the basis of race, color, religion, sex, national origin, sexual orientation, age, or disability in its educational programs or employment policies.”

Past Employment Record: (Start with present position; including student teaching if you’ve completed within the last five years).

SCHOOL OR FIRM and COMPLETE ADDRESS / DATES / NUMBER OF MONTHS / POSITION, GRADE and SUBJECT / REASON FOR LEAVING

List professional activities and honors before and since graduation: ______

______

What position of leadership or responsibility have you held in school/ work? ______

______

What professional organizations are you affiliated with? ______

What periodicals do you read? ______

______

Are you presently under contract with any school system? ______

What school system? ______Until ______

What is the earliest you could begin work in the LCSD? ______

Have you ever been asked to resign, been discharged, or failed to be reemployed for a teaching or administrative position? ______if yes, give details ______

______

Have you ever been convicted of an offense other than a misdemeanor? ______

If yes, explain ______

READ CAREFULLY

The information contained herein is true and represents me accurately. If employed, I agree to abide by all the policies approved by the Board of Trustees and will cooperate fully with in-service programs for professional improvement. I agree that any omissions or false statements will constitute reasons for dismissal.

______

Signature of Applicant

APPLICATION INSTRUCTIONS – CERTIFIED PERSONNEL

PROFESSIONAL EMPLOYMENT APPLICATION

410 Constitution Avenue – 3rd Floor

PO BOX 5498

Meridian, Mississippi 39302

To be considered an official applicant to the Lauderdale County School District, the following must be completed:

1.Application Form – Completed, dated, and signed.

2.Mississippi Certification – Before a teaching certificate can be issued by the State Department of Education, all prospective teachers applying for a Mississippi Certificate for the first time must take the Praxis Examination and make a prescribed score on the common or core battery and subject area examination; scores will vary depending upon the subject area. Scores on the Praxis must be reported directly to the Office of Teacher Certification, State Department of Education, PO Box 771, Jackson, Mississippi, 39205, in order to secure a teaching certificate. If you do not have a valid certificate, you must apply for one and be eligible to receive a certificate before you will be considered for employment in the Lauderdale County School District. Application forms can be obtained from the Human Resource director or by writing the State Department of Education at the above address or by calling (601) 359-3483.

3.Recommendations – At least three references received from those listed on the application. Recommendation forms will be sent directly from the Human Resource office to the persons listed. Unless otherwise directed in writing, these recommendations are confidential and the applicant waived the right of review.

4.Transcripts of all college and/or university work received.

5.Resume’ may be attached to your application.

6.Interviews – After all of the above information has been evaluated, the top applicants will be invited for personal interviews before a person or before a screening committee.

7.Status of Application– Because of the large number of application received and because of the time and fiscal constraints, you may not be contacted unless you are invited for an interview. Your understanding would be appreciated. Applications will remain in the active file only for the school year for which applicant is applying and then they will be classified as inactive unless the applicant notifies the Human Resource office in writing to keep the application current.

8.IF EMPLOYED, you must furnish the Lauderdale County School District with the following:

(A) Mississippi Certification; (B) Birth Certificate; (C) Verification of Prior Teaching Exp. (if applicable); and (D) Social Security Card.

“It is the policy of the Lauderdale County School District not to discriminate on the basis of race, color, religion, sex, national origin, sexual orientation, age, or disability in its educational programs or employment policies.”

Your application is greatly appreciated. Thank you for your interest in the Lauderdale County School District.

Lauderdale County School District
301 46th Court – Meridian, MS 39305 or PO BOX 5498 - Meridian, MS 39302