Personal Information
First Name*
##first_name##
Address
Street Address*
##streetaddress##
Cell Phone*
##cellphone##
Primary Email Address*
##email##
Secondary Email Address
##secondary_email##
Driver's License#
##license##
Driver License State
##driver_license_state##
Driver's License Expiration Date
##expiration_date##
Are you bilingual?
##is_bilingual##
If yes, please list language(s)
##language##
Preferences
Instructional Programs - Please select the program(s) of interest.
##instruction_programs##
Employment Position - Please select the position(s) of interest.
##employment_position##
District
##preference_other##
District
##preference_district##
School
##preference_school##
Employment History
Employer
##current_employer##
Position
##current_position##
Supervisor Name
##current_supervisor_name##
Address
Street Address
##current_street_address##
City
##current_city##
State
##current_state##
Zip Code
##current_zip_code##
How long have you been employed?
##current_been_employed##
May We contact?
##current_can_contact##
Previous Employer
Employer
##previous_employer##
Position
##previous_position##
Supervisor Name
##previous_supervisor_name##
Address
Street Address
##previous_street_address##
City
##previous_city##
State
##previous_state##
Zip Code
##previous_zip_code##
How long have you been employed?
##previous_been_employed##
May We contact?
##previous_can_contact##
Reason for leaving?
##previous_leaving_reason##
Training, Credentials, Education and References
Educational Training Background –
Please list any specialized educational training , certificates and/ or completed courses.
##education##
Do you hold a valid California Teaching Credential?
##teaching_credential##
Issue Date
##education_issue_date##
Expiration Date
##education_expiration_date##
College or University Attended (name and address)
##college_attended##
Degree
-
Expiration Date of most recent TB clearance
##tb_clearance_date##
Have you ever been convicted of a felony?
##is_felony##
If yes, please explain below
##is_felony_reason##
Reference 1
Name
##reference1_name##
Phone Number
##reference1_phn_no##
Address
##reference1_address##
Reference 2
Name
##reference2_name##
Phone Number
##reference2_phn_no##
Address
##reference2_address##