APPLICATION FOR



APPLICATION FOR

SUBSTITUTE TEACHER

KIRKSVILLE R-III School District

1901 E. HAMILTON KIRKSVILLE, MO 63501

PHONE: (660) 665-7774 FAX (660) 665-3281

DATE: ____________________________________

NAME: ____________________________________ E-MAIL: ____________________________________

ADDRESS: ________________________________ PHONE #: __________________________________

________________________________ SOC. SEC. #: _______________________________

I WILL BE AVAILABLE EFFECTIVE (DATE):___________________________________________________________

ARE YOU AVAILABLE SPECIFIC TIMES?______________________________________________________________

I PREFER TO SUBSTITUTE ONLY IN THE FOLLOWING AREAS: _______________________________________

______________________________________________________________________________________________________

I HAVE HAD THE FOLLOWING TEACHING EXPERIENCE:_____________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________

IMPORTANT REQUIREMENTS:

CERTIFICATION: PLEASE CHECK ONE:

MISSOURI SCHOOL LAW (MoSL 168.011) ______ I have a Missouri Certificate to teach.

Requires that we have a copy of your Missouri

Certificate ON FILE in the Office of the ______ I have a Missouri Substitute Teaching Cert.

Superintendent BEFORE you may substitute

in any classroom.

BACKGROUND CHECKS, WITHHOLDING (W-4) AND (I-9)

The Payroll Department cannot issue paychecks to any person who has not completed a State and Federal W-4, I-9 and completed an automatic check deposit form. All I-9 forms will be E-Verified after the Board approves your employment. At that time you will be requested to bring original documentation to payroll as supporting documentation.

FBI/Highway Patrol Background Check Procedures: You must register with MACHS – machs.. The District Substitute Registration Number is 0049. Please follow

the instructions on the attached page.

We are an Equal Opportunity Employer

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