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Instructor Application727897173355Today’s DateFirst Date Available to WorkFor Each Day, List the Hours You Are Available to Work Monday_______________Friday _______________Tuesday_______________Saturday ______________Wednesday_____________Sunday ________________Thursday______________Personal InformationNameAddressHome PhoneCell PhoneEmail Were you referred by anyone to Mathnasium?For background checks, is there any other name that identifies you? If so, please state.Are you over the age of 18?Are you legally able to work in the U.S.?Have you ever been convicted of a crime? If so, please provide detail.Math CompetencyWhat is the most recent math class you’ve taken, and what was your grade?What is the highest-level math class you’ve taken for which you received a grade of A- or better?Optional: Provide further explanation about math competency, including participation in math clubs or competitions, math scores on the SAT or ACT, etc.Educational BackgroundComplete for each high school and college/university or graduate school attended.Name of SchoolDates Attended (leave blank for high school)Did you Graduate? If So, List DegreeMajor, Minor, & GPAEmployment or Volunteer ExperiencePresent/Most Recent EmployerEmployerDates EmployedSupervisor Title, Name, and Contact InfoJob Title and Brief Description of RoleReason for Leaving/Wanting to LeaveFormer EmployerEmployerDates EmployedSupervisor Title, Name, and Contact InfoJob Title and Brief Description of RoleReason for LeavingFormer EmployerEmployerDates EmployedSupervisor Title, Name, and Contact InfoJob Title and Brief Description of RoleReason for LeavingOther Relevant InformationDescribe any additional experience or skills (not covered previously) that you would bring to the position. Include teaching or tutoring experience, experience working with children, leadership roles in organizations, etc.Why are you interested in working for Mathnasium?Are you willing to work at multiple locations if needed? Please circle/highlight each Mathnasium location you are willing to work at.ARCADIA (47st & Indian School) SCOTTSDALE (Via Linda & Shea) NORTH SCOTTSDALE (Pima & Thompson Peak Pwky)PARADISE VALLEY (Tatum & Cactus) NORTH CENTRAL PHOENIX (12st & Glendale)How many hours did you prefer to work each week?_______________________________________ReferencesList three professional references. At least two must be teachers, professors, supervisors, or other individuals in a leadership role over you. Do not list family members.NameRelationshipPhoneEmailApplicant StatementI have answered all questions to the best of my ability. If employed, I realize false information will be grounds for dismissal. I understand that the completion of this application obligates neither me nor the employer to pursue the application or employment process. I authorize Mathnasium or its representative to contact anyone it deems appropriate to verify information I have given or to discuss my background, past performance, or suitability for employment. I also consent to being discussed by persons contacted and waive all rights to bring any action for defamation, invasion of privacy, or similar cause against anyone contacted. I understand that if offered a position, I will be required to submit employment eligibility proof (I-9) and pass a criminal background check.I understand that the position for which I am applying is an “at-will” position and that if I become employed either I or the employer may terminate the employment at any time with or without cause or notice.NameSignatureDate ................
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