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SCHOOL DISTRICT OF HILLSBOROUGH COUNTY
APPLICATION CENTER 1202 EAST PALM AVENUE TAMPA, FLORIDA 33605 Name: ______________________________________________________
http://apps.sdhc.k12.fl.us (Last) (First) (Middle)
AN EQUAL OPPORTUNITY EMPLOYER – School Board Policy 6.01 ensures equal
opportunity for all in its personnel policies and practices and does not discriminate on the
APPLICATION FOR EMPLOYMENT basis of race, color, sex, religion, national origin, marital status, disability or age.
APPLICATIONS MUST BE COMPLETE AND RENEWED YEARLY Transcripts are required as applicable. This application will be considered only if it has been
completed fully and accurately. Offers of employment are subject to proper qualifications and/or certification. School District of Hillsborough County workplaces are drug-free. Employees are
prohibited from engaging in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance. Violation of this prohibition shall result in appropriate disciplinary
action up to and including termination. NOTE: CURRENT AND/OR FORMER EMPLOYEES - DO NOT COMPLETE THIS APPLICATION. INSTEAD, COMPLETE THE APPLICATION UPDATE FORM.
I AM APPLYING FOR THE FOLLOWING POSITION(S): I AM APPLYING FOR THE FOLLOWING POSITION(S):
EXECUTIVE, ADMINISTRATIVE, MANAGEMENT - All the positions in this job family INSTRUCTIONAL SUPPORT - All the positions in this job family require at least a High
require at least a Master's Degree from an accredited college or university or equivalent School Diploma/GED Equivalent. Some require additional certification and/or degrees.
responsible related experience.
Substitute Teacher Assistant Teacher, Instructor
Superintendent Operations/Program Area Administrator/Manager Classroom Paraprofessional Child Care Worker
Organizational Area Senior Executive Principal, Assistant Principal or Site Administrator Student Services Paraprofessional Speech Assistant
INSTRUCTIONAL PROFESSIONAL - All the positions in this family require at least a OPERATIONS SUPPORT - All the positions in this job family require at least completion of
Bachelor's Degree from an accredited college or university. (* Bachelor’s or Associate’s 6th grade education or higher. Some require additional certification and/or degrees.
Degree and/or equivalent related experience)
Student Nutrition Services Automotive/Equipment Repair & Maintenance
Classroom Teacher School Psychologist Bus Driver Custodial, Maintenance, Grounds
Media Specialist Resource Teacher Purchasing and Warehouse Skilled and Unskilled Labor
Guidance Counselor Professional Trainer
Guidance Resource Teacher Speech Therapist _____________________________________________________________________________________
School Social Worker Educational Career Specialist * Telephone # SS #
TECHNICAL PROFESSIONAL - All the positions in this job family require at least a High PERMANENT ADDRESS:
School Diploma/GED Equivalent. Some require additional certification and/or degrees.
_____________________________________________________________________________________
Nursing Personnel Fiscal, Budget, Purchasing, Risk Analysts Street/Apt.
Audiologist Investigator, Security, Safety Specialist _____________________________________________________________________________________
Programmer, Network Analyst Engineer, Architect, Inspector City/State/Zip E-Mail
TEMPORARY ADDRESS:
Administrative, Executive Assistants Benefits, Personnel Specialist
Auditor, Accountant Occupational, Physical Therapist _____________________________________________________________________________________
Street/Apt.
CLERICAL SUPPORT - All the positions in this job family require at least a High School _________________________________________________________
Diploma/GED Equivalent. Some require additional certification and/or degrees. City/State/Zip
Clerk Customer Service Representative Are you a citizen of the United States of America?
Secretary Receptionist Yes
Bookkeeper Registrar No, but I have a current, valid employment work authorization.
Data Processor Office Network Computer Specialist No, but I have a previous H-1B-Visa that I need to refile.
No, I need sponsorship. I do not have employment work authorization.
PERSONAL:
Are you a veteran of the U.S. Military? Yes No
(Complete the Attached Veterans' Preference Form if Applicable.)
Are you in the National Guard or the U.S. Armed Forces Reserves? National Guard Reserves Neither
_________________________________________________________________________________________________________
Have you ever been an employee of the School District of Hillsborough County in any job? Yes No
If yes, under what name were you employed? ___________________________________________________
__________________________________________________________________________________________________________
Must your records be withheld from release in accordance with the Public Records Law? Yes No
__________________________________________________________________________________________________________
We ask for your ethnicity so we may judge our hiring practices and Equal Employment Opportunity compliance. It WILL NOT be
.
used in making employment decisions, except as allowed by law.
American Indian/Alaskan Native Multi Racial
Asian Pacific Islander None Selected
Black, Non Hispanic None of the Above
Hispanic White, Non-Hispanic
__________________________________________________________________________________________________________
CERTIFICATION/LICENSURE:
1. If you have an Educator Certificate or Professional/Technical License, please provide the following information:
(Please note: Statement of Eligibility is not a teaching certificate.)
List Certification/License Coverage(s) on your certificate/license:_____________________________________________
State Issuing Certificate/License: ___________________ Validity Dates: _______________ to __________________
MM/DD/YYYY MM/DD/YYYY
Type of Certificate/License: Temporary Professional Other
Certificate/License Number: ____________________
2. Has action ever been taken against your certificate by any Education Practices Commission? Yes No
If yes, attach a copy of any Final Order(s) that was (were) issued.
3. Have you ever had any professional license (a driver's license is not a professional license) or professional certificate,
including a teaching certificate, sanctioned by the issuing agency in this or any state? Sanctioned is defined to include
suspension, revocation; discipline, such as issuance of a reprimand or fine; or, otherwise conditioned, such as placed on
any restriction or probation. Yes No
4. Have you ever resigned, surrendered, or otherwise relinquished a professional license or certificate in this or any state?
Yes No
5. Is there any action pending in this or any state against a professional license or certificate you hold or held?
Yes No
6. Is there any action pending in this or any state against an application for a professional license or certificate you have on
file? (A determination of academic ineligibility is not considered denial of a license or certificate.) Yes No
IF YOU ANSWERED YES TO ANY OF THE QUESTIONS 3 THROUGH 6, PLEASE EXPLAIN THE
CIRCUMSTANCES ON THE ATTACHED/DOWNLOADED CERTIFICATE/LICENSE ACTION FORM
AND SEND FORM TO THE APPLICATION CENTER.
CRIMINAL HISTORY:
ATTENTION: PLEASE READ VERY CAREFULLY.
Under provisions in Florida Statutes 943.0585 and 943.059, the entire arrest record is revealed to
school districts by the Florida Department of Law Enforcement and the FBI when fingerprints are
supplied, including "sealed records" and "expunged records." Therefore, you are required to reveal
such information on the criminal history form.
Be aware that falsification of records includes omission of information and constitutes grounds for
dismissal. Conviction of a crime will not necessarily be a bar to employment. Factors such as age at
the time of the offense, type of offense, remoteness of the offense in time and rehabilitation will be
taken into account in determining effect on suitability for employment.
Check either “Yes” or “No” next to each question.
Have you ever been arrested or charged for a criminal offense other than a minor traffic violation? Yes No
NOTE: DUI’s are NOT “minor” traffic violations.
Is there any criminal charge now pending against you other than a minor traffic violation? Yes No
NOTE: DUI’s are NOT “minor” traffic violations.
Are you currently on probation or currently under any imposed requirements for charges other Yes No
than a minor traffic violation? NOTE: DUI’s are NOT “minor” traffic violations.
If YES to any of the above, download the CRIMINAL RECORD INFORMATION form, complete it, and send it with this
application to the Application Center.
EDUCATIONAL PREPARATION:
Circle the Highest Grade Completed
General Education College Graduate School
6 7 8 9 10 11 12 1 2 3 4 1 2 3 4
Graduated or
Name School Level Diploma Date Received If Applicable,
of or Degree Degree or Date Answer Questions
School Attended City, State Type Anticipated Below
MM/DD/YYYY
If you did not graduate, do
High School or Last School Attended you have a GED certificate?
Yes □ No □
____________________________ If yes, date issued:_________
City, State
Business/Trade/Tech College/University Major Subject:
________________
____________________________ Minor Subject:
City, State
Business/Trade/Tech College/University Major Subject:
________________
____________________________ Minor Subject:
City, State
Business/Trade/Tech College/University Major Subject:
________________
____________________________ Minor Subject:
City, State
WORK EXPERIENCE AND/OR TEACHING EXPERIENCE:
(List Present/Recent Position First)
(LIST INTERNSHIP/STUDENT TEACHING; DO NOT LIST PRACTICUM)
Name of Business/School From To
City, State Phone Your Title
and Supervisor (MM/DD/YYYY) (MM/DD/YYYY)
_______________________ ______________
Full-time Part-time
_______________________ ______________
Full-time Part-time
_______________________ ______________
Full-time Part-time
_______________________ ______________
Full-time Part-time
_______________________ ______________
Full-time Part-time
_______________________ ______________
Full-time Part-time
_______________________ ______________
Full-time Part-time
REFERENCES:
List two professional references, including principals (current and/or last) and supervisors. Please provide correct addresses
which are legible and complete.
Employment Outside of Education: Provide the name of at least one immediate supervisor.
Applicants who have never been employed should provide two personal references.
IF YOU ARE A TEACHER APPLICANT:
Experienced Teacher: Provide the name of your most recent principal or immediate supervisor.
Recent Graduate: Provide names of both the directing teacher and the principal of the internship school.
Area Code and
Reference’s Name and Position Name of School/Business City, State and Zip Telephone Number
____________________________
Name
______________________________________
Position
____________________________
Name
______________________________________
Position
yS
School District of Hillsborough County
Mail to:
Providence C. Velasco Student Services Center
ATTN: APPLICATION CENTER
1202 East Palm Avenue
Tampa, Florida 33605
I, ________________________________, certify that the answers and statements I have provided to the
questions on the employment application are true and correct without any falsifications, omissions, or
misleading statements of any kind whatsoever. I agree that the District School Board of Hillsborough
County shall not be held liable in any respect if I am not employed or if my employment is terminated
because of false or misleading statements or answers or omissions made by me in this application.
Signature of Applicant: ______________________________________
Printed Name: ______________________________________
Social Security Number: ______________________________________
Date Signed: ______________________________________
____________________________________________________________________________________
Please remember to attach any other required documents. If at any time you wish to view your
application, please visit our website and login to the application section using your User Name and
Password. (If you did not apply online, you may still login – but first you will need to retrieve your
assigned User Name and Password. To do so, go to the Human Resources website
(http://apps.sdhc.k12.fl.us/hrdiv/), click on APPLICATION FOR EMPLOYMENT (on the left side of the
Human Resources home page) * find the area in the center of the page that says: “DO YOU NEED YOUR
USER NAME AND PASSWORD?” and follow the directions below it to retrieve your USER NAME and
PASSWORD * Return to the Login page to login to the Application for Employment. Once logged-in, you
may see your current application status, and links to any documents you may need to complete and send to
Application Center.)
YOUR APPLICATION MUST BE SUBMITTED WITH ALL REQUIRED DOCUMENTS.
After signing and dating this signature form, please make a copy for your records and mail the original to
the address at the top of this signature form.
AN EQUAL OPPORTUNITY EMPLOYER
School Board Policy 6.01 ensures equal opportunity for all in its personnel policies and practices and does not discriminate on the
basis of race, color, sex, religion, national origin, marital status, disability, or age.
Raymond O. Shelton School Administrative Center • 901 East Kennedy Boulevard • Tampa, Florida 33602-3507
Office: Phone: 813-272-4148 • SUNCOM 547-4148 • School District Information 813-272-4000 • Fax: 813-272-4686
P.O. Box 3408 • Tampa, FL 33601-3408 • Web Site: http://apps.sdhc.k12.fl.us
