Classified Application Form for Teacher Assistant - Faith School ...

FAITH SCHOOL DISTRICT #46-2TEACHER ASSISTANT APPLICATION FORMIt is the policy of the Faith School District #46-2 that no person be subjected to discrimination onthe basis of race, national origin, religion, sex, age, physical or mental disabilities, or maritalstatus in any program, service, or activity for which the school district is responsible as requiredby Title IX, P.L. 93-112, Sec. 504, and other state and federal laws.(Please type or print)Name __________________________________________________________________Address _________________________________ Phone _______________________Social Security Number _____________________POSITION APPLYING FOR: ____________________________________________LIST NAME, ADDRESS & PHONE # OF THREE PERSONAL REFERENCES:________________________________________________________________________________________________________________________________________________________________________________________________________________________LIST SKILLS OR EXPERIENCE PERTINENT TO THIS JOB:________________________________________________________________________________________________________________________________________________________________________________________________________________________EDUCATION AND TRAININGCircle last year completed: ED 8 9 10 11 12 13 14 15 16 17 18LIST SCHOOLING AND/OR TRAINING:________________________________________________________________________________________________________________________________________________________________________________________________________________________

Beginning with your present or last work, complete fully, especially description of duties,responsibilities and number you supervised. Include volunteer work.Employed from _____ to _____ Total years _____ Months _____ Hours per week _____Position held _______________ Starting salary __________ Last salary _____________Reason for leaving _______________________ Name of employer _________________Street ____________________ City ____________________ State ______ Zip _______Immediate supervisor ________________________________ Title _________________Description of duties ______________________________________________________________________________________________________________________________Employed from _____ to _____ Total years _____ Months _____ Hours per week _____Position held _______________ Starting Salary __________ Last salary _____________Reason for leaving _______________________ Name of employer ________________Street _____________________ City ____________________ State ________ Zip ____Immediate supervisor _________________________________Title ________________Description of duties ______________________________________________________________________________________________________________________________ADDITIONAL QUESTIONS:Have you ever been convicted of any felony crime? Yes _____ No _____If Yes, please explain___________________________________________________.Have you ever been discharged from a position? Yes______ No_______If yes, please explain on a separate sheet.Do you have a valid driver’s license? yes _____ no _____I hereby authorize representatives of the Faith School District #46-2 to obtain information about me frommy current or previous employers with the knowledge that any false information may be grounds forrejection, or termination of employment. I certify the correctness of the information I have provided on thisform._______________________________________Signature________________________________Date

Name of Applicant: _____________________________________________Respond in paragraph form and use additional paper if necessary.1. Please describe previous experiences that you believe will contribute to your success as a teacherassistant in Faith.2. What special or unusual talents would you bring to this position?3. What are the characteristics of an effective teacher assistant?4. Describe why this position would be a good match for you.Thank you for your interest in the students of Faith School District.