Mid-Ohio Educational Service Center



-184785-122555 MID-OHIO EDUCATIONAL SERVICE CENTER Substitute Teacher Application Crawford, Morrow and Richland Counties2019 – 2020 PLEASE PRINT CLEARLYName:_____________________________________________________________ Date:_________________________ Address: ____________________________________ City: _______________________ State: _____ Zip:________Date of Birth: ________________________________ Contact Phone #: ____________________________________Email ___________________________________________________________________________________________ If you are a certified teacher are you interested in tutoring? □ Yes center52705**AN ADDITIONAL APPLICATION MAY BE REQURED BY A DISTRICT TO BE COMPLETED. PLEASE CONTACT THE DISTRICT**00**AN ADDITIONAL APPLICATION MAY BE REQURED BY A DISTRICT TO BE COMPLETED. PLEASE CONTACT THE DISTRICT**Select the school district(s) in which you would like to substituteCrawford County:□ Colonel Crawford □ Crestline □ Galion □ WynfordMorrow County: □ Highland □ NorthmorRichland County:□ Crestview □ Lexington □ Lucas □ Madison □ Pioneer CTC □ Plymouth-Shiloh Alternative Schools: Community / Non-Public: □ Foundation Academy □ Abraxas □ FIRST School □ Mansfield Christian □ St. Peter’s School (7 – 12 only 399478561595Substitute teachers may be discharged for any reason without recourse to the grievance procedure. Substitute teachers may also be removed from the substitute call list at the discretion of each individual school district.~ Mid-Ohio Educational Service Center is anEqual Opportunity Employer ~00Substitute teachers may be discharged for any reason without recourse to the grievance procedure. Substitute teachers may also be removed from the substitute call list at the discretion of each individual school district.~ Mid-Ohio Educational Service Center is anEqual Opportunity Employer ~I understand that falsification of any and all information on this application shall result in my being disqualified as a substitute teacher. By affixing my signature on this application, I agree to all the conditions listed in the substitute teacher packet. 2594610317512700635000right212090Please return this application, along with a $22 application fee, to Mid-Ohio ESC. Make checks payable to Mid-Ohio ESC00Please return this application, along with a $22 application fee, to Mid-Ohio ESC. Make checks payable to Mid-Ohio ESCApplicant Signature Dateright243840OFFICE USE ONLY□ $22 Application Fee Date Paid ___________________ □ Transcripts □ BCI/FBI □ TB Test Results □ 2018-2019 Returning Sub 00OFFICE USE ONLY□ $22 Application Fee Date Paid ___________________ □ Transcripts □ BCI/FBI □ TB Test Results □ 2018-2019 Returning Sub 890 West Fourth Street, Suite 100, Mansfield, Ohio 44906 Phone: 419-774-5520 Fax: 419-774-5523 ................
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