€¦ · Web viewWe will not discriminate and will take measures to ensure against discrimination in employment, recruitment, advertisements for employment, compensation, termination,

Application for Teacher

We believe that the most important component for the success of our school is a dedicated and excellent faculty with a testimony beyond reproach.

Date: ______________________Position:____________________________________

A) PERSONAL INFORMATION

Date of Birth:___________________________

Name: ___________________________________________SSN:_________________________

Address:_________________________________________

__________________________________________ Length at this address:___________

Previous Address:________________________________________

___________________________________________Length at this address:__________

Phone:________________________Cell:____________________Email:____________________

Church Affliliation:______________________________________Member_____yes________no

Marital Status: Married_____Single______Never Married______Engaged___________ Divorced_____Separated_______Re-Married_______Widowed_______ Spouse’s Name____________________Years Married:______________

Military Status:____________________________________________________________

B) EDUCATION: School Degree Dates GPA

High School____________________________________________________________________

College________________________________________________________________________

2485 B Lost Mountain Rd. Wirtz, Va 24184 www.smlca.org 540-719-1192

College Transcripts will be required.

List other academic pursuits (Training Programs, conferences, seminars):_______________________________________________________________________________________________________________________________________________________________________________List all Certifications/Licenses (areas, levels):______________________________________________________________________________________________________________________________________________________________________________________________________List any honors or awards from college to present:_________________________________________________________________________________________________________________________________________________________________________________________________

C) TEACHING EXPERIENCE:______________________________________________________________________________Dates School Name School Address______________________________________________________________________________Subject(s) Grade Level #Students______________________________________________________________________________Supervisor Supervisor Phone/Email______________________________________________________________________________Reason Left______________________________________________________________________________Dates School Name School Address______________________________________________________________________________Subject(s) Grade Level #Students______________________________________________________________________________Supervisor Supervisor Phone/Email______________________________________________________________________________Reason Left______________________________________________________________________________Dates School Name School Address______________________________________________________________________________Subject(s) Grade Level #Students______________________________________________________________________________Supervisor Supervisor Phone/Email______________________________________________________________________________Reason Left


D) WORK EXPERIENCE:______________________________________________________________________________Dates Name of Establishment Title Supervisor______________________________________________________________________________Reason Left______________________________________________________________________________Dates Name of Establishment Title Supervisor______________________________________________________________________________Reason Left______________________________________________________________________________Dates Name of Establishment Title Supervisor______________________________________________________________________________Reason LeftE) CHRISTIAN AND EDUCATIONAL PHILOSOPHY:

On a separate sheet, please answer or discuss the following in one-two paragraphs:1. Briefly describe your salvation experience.2. What is your description of a biblical worldview?3. Describe events or circumstances that confirm God’s calling for you to be a teacher.4. What intentional steps do you take to grow in Christ?5. Comment on Jesus’ statement that it would be better to have a millstone tied around

your neck and thrown into a lake than to lead a little one astray.6. Why do you want to teach at SMLCA?7. Share one moment in your teaching experience where all of your training, experience

and hard work paid off.8. List all extra-curricular activities (arts, athletics) with which you have experience

F) REFERENCE:Current Pastor:Name:__________________________________Phone:______________________________Address:____________________________________________________________________Relationship:_____________________________E-Mail:_____________________________

Non-pastoral Spiritual Reference (someone who knows you well):Name:__________________________________Phone:______________________________Address:____________________________________________________________________Relationship:____________________________E-Mail:_______________________________

Education Supervisor (most recent):Name:__________________________________Phone:______________________________Address:_____________________________________________________________________Relationship:_____________________________E-Mail:_______________________________


One more of your choices:Name:__________________________________Phone:________________________________Address:______________________________________________________________________Relationship:_____________________________E-Mail:________________________________

G) LEGAL QUALIFICATIONS:(If you answer “yes” to any of the below questions in this section, please attach a separate sheet indicating the nature of the suit, offense, date, court, and disposition or other appropriate explanations.)

Are you presently being investigated or under a procedure to consider your discharge for misconduct by your present employer or, if you offered a resignation, your previous employer?Yes_____No_______

Have you ever been discharged or asked to resign from a prior position?Yes_____No_______

Have you ever been denied a license?Yes____No________

Have you ever been convicted (in civil or criminal proceedings) of any offense involving improprieties regarding children?Yes_____No_______

Have you ever been convicted of any crime other than the above (omit minor traffic offenses)?Yes_____No_______Have you ever entered a court plea of guilty, or “no contest” (nolo contendere), or has any court ever deferred further proceeding without entering a finding of guilty, and placed you on probation or in a public service or education program for any crime other than a minor traffic offense?Yes_____No_______


Non-Discrimination Statement and Policy

Smith Mountain Lake Christian Academy is an equal opportunity employer. We will not discriminate and will take measures to ensure against discrimination in employment, recruitment, advertisements for employment, compensation, termination, upgrading, promotions, and other conditions of employment against any employee or job applicant on the basis of race, color, gender, national origin, age, creed, disability, or veteran’s status.


Agreement of Principals and Release of Information

____I agree with and will abide by all the principles set forth in the preceding documents, without reservation. (This is not necessarily a prerequisite for employment. Please fill in below.)

_____I agree with and will abide by all the principles set forth in the preceding documents with the exception of ______________________________________________________because___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I grant permission for SMLCA to contact all employers and references listed. I also understand a criminal background check, including a FBI fingerprint review, is required for employment. I understand that if any information provided in this application proves to be false or intentionally misleading, it could disqualify my standing as a prospective applicant and could result in terminating my employment without future remuneration. I waive any right to personally review any reference information provided on my behalf.

I understand that SMLCA does not discriminate in its employment practices against any person because of race, color, national or ethnic origin, gender, age or disability.

____________________________________________ Date:____________________________Signature

____________________________________________Printed

Mail this completed form to: Smith Mountain Lake Christian Academy2485B Lost Mountain RoadWirtz, VA 24184

Or you may email to: [email protected]


SMLCA Personal Information

Employee Full Name:____________________________________________________________

Date of Birth:________________________________Preferred Name:_____________________________Home Address:______________________________________________________Phone Number:_________________________Email:____________________Church Affiliation:________________________________Member: Yes___No___Pastor Name:___________________________Phone Number:_______________

Spouse Name:_____________________________________________________________Home Address (if other than above):____________________________________Daytime Phone:___________________________Cell:______________________Employer:______________________________Email:_______________________

Emergency Information:IN CASE OF ACCIDENT OR SERIOUS ILLNESS, YOU HAVE PERMISSION TO CONTACT THE FOLLOWING:Emergency Contact:_________________________Relationship:______________Address:___________________________________________________________Phone:_____________________________Cell:____________________________Family Doctor:_________________________________Phone:_______________

Hospital:_____________________________________Phone:________________

Employee Signature_____________________________Date:________________


Documents

€¦ · Web viewWe will not discriminate and will take measures to ensure against discrimination in employment, recruitment, advertisements for employment, compensation, termination,