TEACHER APPLICATION BLANK - Manasquan Public Schools



TEACHER APPLICATION BLANK

Manasquan Board of Education

Manasquan, New Jersey 08736

Interview notations (this section for office use only).

Salary guide credit (years)____________________ Salary quoted___________________

Total graduate credits beyond degree__________ Additional compensation_____________

Comments______________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Interviewed by_______________________________ Date________________________________

Date approved by board of education___________ Starting date, employment_______________

Return this application to

Superintendent

Manasquan Public School District

169 Broad Street

Manasquan, New Jersey 08736

List subject or grade for which you are applying, in order of preference.

1.________________________________________

2.________________________________________

3.________________________________________

1. Name__________________________________________________________________________

(last) (first) (middle or maiden name)

2. Present address________________________________________ Telephone________________

________________________________________

3. Permanent address_____________________________________ Telephone________________

_____________________________________

4. Type of teacher’s certificate held____________________________________________________

5. If you do not hold a certificate, do you have a state evaluation or meet certification requirements for the position?__________ Explain your situation; list deficiencies in subject field or education course requirements.____________________________________________________________________

_________________________________________________________________________________

6. Undergraduate Major________________________________ *Total semester hours_______

Undergraduate Minor________________________________ *Total semester hours_______

*this must be accurate; do not guess or estimate.

7. Educational and professional training.

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|Name of school or institution |Major/Minor |Year graduated or last enrolled |Diploma or degree |

| | | | |

|High sch. | | | |

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|Location | | | |

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|College | | | |

| | | | |

|Location | | | |

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|College | | | |

| | | | |

|Location | | | |

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|Grad.school/other | | | |

| | | | |

|Location | | | |

List all colleges/universities attended. Proof of all degrees and graduate work must be furnished within 10 days of hiring.

8. Teaching experience (include student teaching); ALL teaching experience must be listed.

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|Name of school |Location |Grade/ |Immediate |Dates: |Years & |Reason for |

| | |Subject |Supervisor |From......To |Months |leaving |

| | | | | | | |

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9. Are you under contract at present?_____________________________________________________

10. When will you be available?__________________________________________________________

11. Present salary?_____________________ Lowest salary you would accept?___________

12. Do you possess computer/technology skills?____________________

If so, explain:______________________________________________________________________

_________________________________________________________________________________

13. Are you willing to submit a writing sample during your interview?_____________________________

14. Underline any of the following you can direct and/or coach: debates, school plays, orchestra, clubs, football, soccer, basketball, baseball, softball, track, field hockey, tennis, golf, wrestling, playground activities. Other?__________________________________________________________________________

15. Military service: branch________________________ highest rank______________________

Length of service (years & months)________________; from____________ to______________

Type of discharge__________________________________________________________________

16. Are you a citizen of the United States?_____________

17. Condition of health, past two years__________________________. In the past 12 months, how many days have you lost from work because of illness?____________________________________________

18. Please give any additional information regarding your background or experience; include college activities, honors received, offices held, service club(s) membership, etc.

___________________________________________________________________________________

___________________________________________________________________________________

__________________________________________________________________________________

19. References: give references (with current addresses) including superintendents and principals under whom you have taught and those who have firsthand knowledge of your character, personality, scholarship, and/or teaching ability.

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|Name |Address |Official position or title |

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20. A personal interview is required before any appointment for any position is made. Interviews are not granted until there is a position vacant for which the candidate qualifies.

Applicant’s signature_________________________________________

Social Security number_____________________

Teachers’ Pension Fund account number______________________

Date______________________________________

THE MANASQUAN PUBLIC SCHOOL DISTRICT IS AN EQUAL OPPORTUNITY EMPLOYER

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