Homewood Board of Education by 9riyk4BF


									                                    Homewood Board of Education
                                                  #7 Hollywood Boulevard
                                                   Homewood, AL 35209


Full Name                                                                  Soc. Sec. No.
            Last                    First                Middle

Other name(s) under which records may be filed
                                                  Last                  First              Middle

Address                                                                                    Telephone
          Street                              City                    State/Zip Code

Person to contact in case you cannot be reached
                                                  Name                                                  Telephone

                                  EDUCATIONAL AND PROFESSIONAL TRAINING

Name of Institution                                  Dates Attended             Type of Degree         Month/Year of Grad

High School



Graduate School


What type of teaching certificate do you hold_____________________________________Expires____________________

Subject/grade/assignment preferred:_______________________________________________________________________

                                        EDUCATION/TEACHING EXPERIENCE*

                              Grade/                        Reasons for
    Name of School            Subject       Dates            Leaving            Name/Address/Telephone of Principal

*Do not include internships
                                 WORK EXPERIENCE OTHER THAN EDUCATION

   Position           Employer or Company             Dates       Reason for Leaving               of Supervisor

                                         INTERNSHIP/STUDENT TEACHING

                          Please include information if internship was completed in past five years.

     Name of School            Grade/Subject                       Dates                       of Cooperating Teacher


List three references who have knowledge of the quality of your educational training and/or teaching experiences.

         Name                        to Applicant                          Address                         Telephone

List technical/computer skills which could be beneficial in job performance

List honors/awards received in college or since graduation

List hobbies, interests, and areas of community involvement
In the space provided below, compose a handwritten statement regarding your philosophy of education.

Have you ever been convicted of a felony or misdemeanor other than minor traffic offenses?
______Yes ______No If yes, please explain

Information will be verified with the Administrative Office of the Courts.

Complete applications include the following:
Current resume
Transcripts (undergraduate and graduate)
Copy of teaching certificate (or evidence that it has been applied for)
Evidence of highly qualified status (if applicable)
Three letters of reference from persons familiar with your work as an educator
Applications will remain active for one year.

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge. I also
understand that an employment contract based upon information in this application which later proves to be false or
incomplete shall result in that contract becoming null and void.

                  Signature                                                                           Date

It is the policy of the Homewood City School Board that no person in this district shall, on the basis of race, color, disability,
creed, religion, sex, age, or national origin be denied the benefits of, or be subject to discrimination in any education program
or activity. This includes employment, retention, and promotion.

                                                                                                                     Revised 4/2005

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