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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