APPLICATION FOR SUBSTITUTE TEACHING



APPLICATION FOR SUBSTITUTE TEACHING

NAZARETH AREA SCHOOL DISTRICT

Human Resources Department

One Education Plaza

Nazareth, PA 18064

610-759-1170 ext. 1124

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Date

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|Last Name |First Name |Middle Initial | |Telephone Number |

|      |      |      |      |

|Street Address |Town |State |Zip Code |

|      | |      | |      |

|Subject Certified to Teach | |Social Security Number | |Date of Birth |

|E-mail address (if Available):       |

Regardless of certification, will you substitute in the following areas?:

| | |Yes | |No | |

|Will you substitute for a 1/2 day? (1/2 of $90$100)? | | | | | |

|Will you substitute for a 1/4 day? (1/4 of $90/$100)? | | | | | |

|I am willing to accept employment as a substitute only on the days checked. |

|Monday| | |Tuesday| |

| |960 Bushkill Center Rd., Nazareth | | |355 Tatamy Rd., Nazareth |

| | | | | |

| |F. R. Shafer Elementary School | | |Nazareth Middle School |

| |49 S. Liberty Street, Nazareth | | |94 Friedenstahl Ave., Nazareth |

| | | | | |

| |Lower Nazareth Elementary School | | |Nazareth High School |

| |4422 Newburg Rd., Nazareth | | |501 East Center Street, Nazareth |

| | | | | |

| To be approved as a substitute teacher in the Nazareth Area School District applicants must bring to the personnel office: |

| 1) your original PA teaching certificate |

| 2) your original Criminal History Record Check (current within one year) |

| 3) your original Child Abuse History Clearance(current within one year) |

| 4) FBI Background Check (current within one year) |

| 5) a physical examination form with a TB test (performed within the past year) |

| 6) 2 proofs of ID for the Employment Eligibility Verification Form (I-9 Form) |

Rev. 2009-2010

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