Maryland State Department of Education Office of the ...

Maryland State Department of Education Office of the Deputy for School Effectiveness

Juvenile Services Education System

OPEN AND CONTINUOUS RECRUITMENT

Complete the following information and enclose this form with your application

Applicant's Name:

Country:

Address:

City:

State:

Zip:

Home phone:

Cell:

Email:

POSITION FOR WHICH APPLYING (Check only one per application):

Teacher, Juvenile Special Education

Teacher, Career Technology Education

Teacher, Juvenile Academic Education

Electrical

Reading/Lang Arts

Residential Construction

Science

Computer Business App.

Math

Computer Literacy

Social Studies

Life Skills

ESL/ESOL

Other (Please Specify) :

Other (Please Specify) :

Principal Assistant Principal School Psychologist Teacher Supervisor School Counselor Librarian/Media Specialist Social Worker Other (Please Specify) :

CERTIFICATION:

Have you been or are you currently certified? Yes No Expiration Date:

What State are you certified in? Maryland Other State (Please Specify):

What type of certificate? APC SPC PEC

Conditional Other:

What area and/or endorsements are listed on your certificate (Check all that apply):

Secondary

Language Arts

Guidance Counselor Administrator I

Elementary

Math

School Media

Administrator II

Special Education

Science

School Psychologist

Reading

Social Studies

Librarian

Other:

If not certified (Check all that apply): Passed SLLA Passed Praxis I Passed Praxis II

Scheduled for Praxis Exam Passed NTE Plan to take Praxis

Date: Date: Date:

Willing to work: Part-time Full-time

Are you willing to work in two or more facilities?

Yes No

REGIONS AND FACILITIES YOU ARE WILLING TO WORK (Check all that apply):

Anywhere in the State

Central Region

Eastern Region

Southern Region

Western Region

Baltimore City

Kent County

Anne Arundel County

Allegany County

Baltimore County

Wicomico County

Montgomery County

Garrett County

Frederick County

Prince George's County

Washington County

Juvenile Facilities:

Baltimore City Juvenile Justice Center Charles H. Hickey, Jr. School (Baltimore Co.)

Victor Cullen Center (Frederick Co.)

J. DeWeese Carter Center (Kent Co.) Lower Eastern Shore Children's Center (Wicomico Co.) Thomas J.S. Waxter Children's Center (Anne Arundel Co.)

Alfred D. Noyes Children's Center (Montgomery Co.) Cheltenham Youth Facility (Prince George's Co.)

Western Maryland Children's Center (Washington Co.)

Green Ridge Regional Youth Center (Allegany Co.) Meadow Mountain Youth Center (Garrett Co.) Backbone Mountain Youth Center (Garrett Co.) Savage Mountain Youth Center (Garrett Co.)

Juvenile Services Education (JSE)Application Addendum

MSDE-OHR-REV 12/16 AppAdd 5

O&C

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