STEWART COUNTY BOARD OF EDUCATION

APPLICATION FOR EMPLOYMENT

 

 PO Box 433   1031 Spring Street  Dover, TN  37058 (931) 232-5176  

 

                                                                                                DATE: ___________________

 

NAME:  __________________________________________________________________________________

                        LAST                                       FIRST                                                  MIDDLE

 

ADDRESS:  _______________________________________________________________________________

 

TELEPHONE:  ______________________________                                   ______________________________

                                                HOME                                                                         BUSINESS/OTHER

 

BIRTHDATE:  ____________________                    SSN#:  _________________________________________

 

POSITION APPLIED FOR:                 BUS DRIVER                        ___      *SUBSTITUTE TEACHER                    ___

                                                                FOOD SERVICE                   ___         CUSTODIAN                                        ___

                                                          **TEACHER ASST.  ___         OTHER  (explain)                 _____________________

 

EDUCATION – HIGHEST GRADE COMPLETED _______________________________________________

 

DO YOU AGREE TO MEET REQUIREMENTS RELATIVE TO PHYSICAL EXAMINATION?  _______ YES  _______ NO

 

LIST YOUR LAST FIVE YEARS OF EMPLOYMENT, GIVING NAME & ADDRESS/PHONE NUMBER OF EMPLOYMENT & DATE OF EMPLOYMENT.

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

 

LIST THREE REFERENCES:

NAME                                                                   PRESENT ADDRESS                          PHONE NUMBER                                RELATIONSHIP

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

 

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

 

*IF APPLYING FOR SUBSTITUTE TEACHER:

(1)  DO YOU HAVE A TENNESSEE TEACHING CERTIFICATE?                                _________________________

(2)  WHAT GRADES/SUBJECTS ARE COVERED BY THE CERTIFICATE?               _________________________

 

**A WRITTEN EXAM IS REQUIRED IF APPLYING FOR TEACHER’S ASSISTANT POSITION.

 

NOTE:  THIS APPLICATION WILL STAY ON FILE FOR TWO YEARS

 

PROSPECTIVE EMPLOYEES WILL RECEIVE CONSIDERATION WITHOUT DISCRIMINATION BECAUSE OF SEX, AGE, NATURAL ORGIN OR HANDICAP.

 

IF EMPLOYED, THERE WILL BE A $48.00 FEE FOR TBI BACKGROUND CHECK.  UPON SIX (6) MONTH SUCCESSFUL EVALUATION OF EMPLOYMENT THE $48.00 WILL BE REIMBURSED.  (EFFECTIVE JULY 1, 2000)

 

Stewart County Schools has implemented a Drug Free Workplace Policy in compliance with federal regulations

 

 

“MEETING THE CHALLENGES OF TOMORROW”