STANDARD APPLICATION

1737360495300HERITAGECommunity Charter School1803 E. Ustick Road, Caldwell, ID 83605Office: 208-453-8070 Facsimile: 208-453-80770HERITAGECommunity Charter School1803 E. Ustick Road, Caldwell, ID 83605Office: 208-453-8070 Facsimile: 208-453-8077EMPLOYMENT APPLICATION(Please Print or Type)Position(s) Desired FORMTEXT ?????Name FORMTEXT ????? FORMTEXT ?????LastFirstMiddleToday’s DatePresent Address FORMTEXT ????? FORMTEXT ?????Street(Area Code) Telephone FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????CityStateZip CodeE-mail Address (if available) FORMTEXT ?????List, in order of preference, the grades, subjects and/or positions for which you are applying:1. FORMTEXT ?????2. FORMTEXT ?????3. FORMTEXT ?????CERTIFICATION(list all areas in which you hold valid Idaho and/or out-of-state teaching certificates. Note: Applicants holding a certificate from another state must obtain an Idaho Certificate in order to teach in Idaho Public Schools.)Area of CertificationIssuing StateDate Issued FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Date available for employment FORMTEXT ?????If you are not employed full time, are you interested in being placed on our Substitute List? FORMCHECKBOX Yes FORMCHECKBOX NoLong-term SUB FORMCHECKBOX Yes FORMCHECKBOX NoShort-term SUB FORMCHECKBOX Yes FORMCHECKBOX NoEDUCATIONAL BACKGROUNDSchool or Institution and LocationMajor/MinorDiplomas,Degrees orCredits EarnedDate CompletedHigh School FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????College/University FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????College/University FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Graduate Study FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Graduate Study FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????EXPERIENCE(Present or most recent first)DatesName of Employer and AddressYour TitleFrom FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????To FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????(Area Code) Telephone: FORMTEXT ?????Work Performed:Reason for Leaving: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Name & Title of Supervisor: FORMTEXT ?????Final Yearly Salary: FORMTEXT ?????DatesName of Employer and AddressYour TitleFrom FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????To FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????(Area Code) Telephone: FORMTEXT ?????Work Performed:Reason for Leaving: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Name & Title of Supervisor: FORMTEXT ?????Final Yearly Salary: FORMTEXT ?????DatesName of Employer and AddressYour TitleFrom FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????To FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????(Area Code) Telephone: FORMTEXT ?????Work Performed:Reason for Leaving: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Name & Title of Supervisor: FORMTEXT ?????Final Yearly Salary: FORMTEXT ?????If you have not been previously employed in a teaching position, please complete the following:STUDENT OR PRACTICE TEACHINGGrade or Subject TaughtName and Address of SchoolCollege SupervisorCooperating Teacher FORMTEXT ????? FORMTEXT ?????1. FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????2. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????1. FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????2. FORMTEXT ????? FORMTEXT ?????Student Teaching References: Please attach photocopies of letters of reference and/or evaluations from college/university student teacher supervisor and cooperating teacher(s).REFERENCESReferences should include superintendents, principals or professors who have first-hand knowledge of your professional competence and your personal qualifications. Experienced teachers should include the superintendent and principal of the most recent schools in which employed. If any person(s) listed should not be contacted for reference at the present time, indicate in the left-hand margin the date contact(s) may be made. NamePositionAddressTelephone FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????OTHER QUALIFICATIONSSummarize special job-related skills and qualifications acquired from employment or other experiences (including U.S. military service) and/or state any additional information you feel may be helpful in considering your application, i.e. honors, awards, activities, technology skills or professional development activities: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????ESSAY FOR CERTIFIED CLASSROOM TEACHER APPLICANTSWe are interested in your ability to organize and express thoughts on a specific topic in a succinct manner. Please select one of the following topics and write an essay in the space provided on this page.The Most Important Qualities of an Outstanding Educator.My Philosophy of Student Discipline.My Philosophy of Dual Language Immersion or Classical Education.Essential Elements of Instruction, Administration or Area of Certification.How Information Technology (i.e., computers, Internet) Can Be Integrated into the Instructional Process and Curriculum. FORMTEXT ?????SignatureNameNote to applicants: This application can be downloaded from our District Web Page at . ................
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