Application for Employment   

Personal Information

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail

Please enter your Social Security Number:

Please select the position for which you are applying:

Principal Assistant Principal Grade Level Administrator 6th Grade Language Arts 7th Grade Language Arts 8th Grade Language Arts 6th Grade Math 7th Grade Math 8th Grade Math 6th Grade Social Studies 7th Grade Social Studies 8th Grade Social Studies 6th Grade Science 7th Grade Science 8th Grade Science Paraprofessional/Teacher's Assistant Art Band/Chorus PE Technology Spanish Bookkeeper Clerical Data Processor Student and Personnel Services Clinic Lunchroom manager Lunchroom assistant Custodial ELL ESE Specialist Guidance Counselor After School Director After School Assistant Athletic Director

 

Please provide date available for work:

Education

High School:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Colleges and Universities:

College/University #1

Name of school
Years attended
Major Field
Hours of Credit
Degree
Date Received

College/University #2

Name of school
Years Attended
Major field

Hours of Credit
Degree
Date Received

College/University #3

Name of school
Years Attended
Major field

Hours of Credit
Degree
Date Received

Certifications (must be completed in detail):

Credentials
Area of Study
Hours of credit

Emphasis
Date Received

Credentials #2

Credentials
Area of Study

Hours of Credit
Emphasis
Date Received

Credentials #3

Credentials
Area of Study

Hours of Credit
Emphasis
Date Received

Please list all courses, volunteers work, hobbies or interests that would relate to the position desired (i.e., CPR Certification, First Aid, etc.).

Please list any professional organizations in which you are active:

Are you currently employed?

Yes No

If so, may I contact your current employer?

Yes No

Employment History

Please list last three employers, starting with the most recent.

Name of Employer (#1):

Position

Address:

Supervisor:

Telephone Number:

Length of Employment

Please list your reasons for leaving:

Name of Employer #2

Position:

Address:

Supervisor

Telephone Number

Length of Time Employed

Please list your reasons for leaving:

Name of Employer #3

Position

Address

Supervisor

Telephone Number

Length of time employed:

Please list reasons for leaving:

References

Please list three.

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone

Enter length of time known:

Reference #2

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone

Enter length of time known:

Reference #3

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone

Enter length of time known:

If you are applying for a teaching position, please write a short essay on your pedagogy for preparing middle school students for our 21st century:

Are any of your relatives employed by Terrace Community Middle School?

Yes No

Are you 18 years of age or older?

Yes No

Are you eligible for employment in the United States?

Yes No

If applicable, please specify the type of visa you hold, if required:

CRIMINAL HISTORY:

ATTENTION:  Please read very carefully

Under provisions in Florida Statutes 943.0585 and 943.059, the entire arrest record is revealed to school districts by the Florida Department of Law Enforcement and the FBI when fingerprints are supplied, including "sealed records" and "expunged records."  Therefore, you are required to reveal such information on the criminal history record form (please call 987-6555, ext. 3204 if you require one).

Be aware that falsification of records includes omission of information and constitutes grounds for dismissal.  Conviction of a crime will not necessarily be a bar to employment.,   Factors such as age at the time of the offense, type of offense, remoteness of the offense in time and rehabilitation will be taken into account in determining effect on suitability for employment

              Have you ever been arrested or charged for a criminal offense other than a minor traffic violation? NOTE: DUI's are not "minor" traffic violations

Yes No

              Is there any criminal charge now pending against you other than a minor traffic violation? NOTE: DUI'S are NOT "minor" violations

Yes No

             Are you currently on probation or currently under any imposed requirements for charges other than a minor traffic violation? NOTE: DUI's are NOT "minor" traffic violations

Yes No

             Have you been adjudicated?

Yes No

             If so, please explain the outcome:

In the space provided below, please write a short essay on your pedagogy for preparing middle school students for our 21st century:

It is understood and agreed that any misrepresentation or deliberate omissions by me in this application shall be sufficient cause for separation from Terrace Community Middle School, and give them the right to investigate references and to secure additional job-related information about me.

If I receive an offer of employment, I must be fingerprinted by the Hillsborough County School Board in order to be an employee of Terrace Community Middle School