Boerne Independent School District 123 W. Johns Rd. Boerne, Texas 78006 Phone: 830-357-2000 Fax: 830-357-2089

APPLICATION FOR SUBSTITUTE TEACHER

By completing and submitting this application you are agreeing to complete required fingerprinting at your expense of $47.45. Instructions will be mailed to you regarding this. STATE LAW MAKES THIS A PRE-REQUISITE OF EMPLOYMENT

Date of application: ____________________ School year applying for: _______________ Are you a certified teacher__________ If yes, grade/subject___________________________ l. Personal Data Name: _________________________________________________________________ Last First Middle Address: _______________________________________________________________ Street or P.O. Box _______________________________________________________________ City State Zip Telephone: (_____) _____________________

Cell phone: (_____) __________________

Driver’s license number: __________________________

State ______________________

Please list the states (other than Texas) and the counties that you have lived in for the last seven years: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ II. Educational Background School(s)

Location

Dates

Major

Minor

Degree(s)

Year Earned

III. Certifications Type of Certifications

State

Year Earned

Level

Teaching Fields/Endorsements

Are you a retired TRS member? Circle one: YES NO If yes, date of retirement: ___________________________ Has your educator certificate ever been sanctioned, suspended or revoked? Circle one: YES NO If yes, please explain: ________________________________________________________________________ ________________________________________________________________________ IV. Experience/Work History Names of Schools/Employers

Location

Dates

Last Position

Reason for Leaving

V. References Name

Address

Phone

Position

VI. General Information 1. List any college honors or activities: ________________________________________________________________________ ________________________________________________________________________ 2. List any community involvement, hobbies and/or interests: ________________________________________________________________________ ________________________________________________________________________ 3. List any additional information you would like us to consider: ________________________________________________________________________ ________________________________________________________________________ 4. Have you ever been convicted of or pleaded guilty or no contest (no lo contendere) to, or received probation, suspension, or defer adjudication for a felony

or offense involving moral turpitude (including, but nor limited to, theft, rape, murder, swindling, and indecency with a minor)? Circle one: YES NO If yes, please state where, when, and the nature of the offense: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 5. For the period of ten years prior to the date of this application, have you been terminated or non-renewed by any employer (including school districts)? Circle one: YES NO If you have answered yes, please explain: ________________________________________________________________________ ________________________________________________________________________ 6. Please tell us what interests you in substitute teaching and why you are applying: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 7. If you have a degree, please attach a copy of your college transcripts or diploma. Non-degreed please attach a copy of verification of high school graduation. Certified teachers please attach a copy of your teaching certificate(s). 8. List any needed accommodations, if applicable, for: □ Training session________________________________________ □ Classroom_____________________________________________ □ Office_________________________________________________ YOUR APPLICATION MUST BE SUBMITTED WITH A COPY OF YOUR SOCIAL SECURITY CARD AND CURRENT DRIVER’S LICENSE.

____________________________________ Signature

_____________________ Date

NOTICE The Boerne ISD complies with all federal and state equal employment opportunity laws and does not discriminate on the basis of race, color, national origin, sex, disability, age, limited English proficiency or any other basis prohibited by law. While convictions will not necessarily disqualify an applicant from the job for which he or she has applied, such information may be taken into account in determining whether the conduct related to the conviction or investigation is reasonably related to the job for which the applicant has applied. Responses to these questions will be kept confidential and will be used solely for the purposes of initiating further inquiry into an applicant’s criminal history. Rev. 09/2013

BOERNE INDEPENDENT SCHOOL DISTRICT 123 W. Johns Rd. Boerne, Texas 78006 830-357-2000

CRIMINAL HISTORY CONSENT FORM AND WAIVER FOR EMPLOYMENT WITH THE BOERNE ISD FOR CERTIFIED & NON-CERTIFIED ADMINISTRATIVE, TEACHING, AND SUBSTITUTE TEACHING POSITIONS Texas laws require the Boerne ISD as a school district to conduct criminal history checks on its certified and non-certified administrative, teaching, and substitute teaching employees and job applicants. Section 22.083 of the Texas Education Code provides that school districts shall obtain criminal histories on school district employees generally. Sections 22.0831 and 22.0836 of the Texas Education Code require persons who seek certified or substitute teaching positions to submit to a national criminal history check. Such persons do so by being fingerprinted. Fingerprinting is mandatory for both employees and applicants who are offered positions or who are engaged as probationary employees pending the results of the criminal history process. The offer of employment to a certified administrative, teaching, or substitute teaching (certified or non-certified substitutes) applicant or the continued employment of the person as a probationary employee will be contingent upon the occurrence of two events: 1) fingerprinting compliance in accordance with a schedule directed by the Boerne ISD; and 2) a criminal history report that does not violate the requirements of Texas law or otherwise preclude employment or continued employment under discretion allowed to school districts under state and federal law. The offer of employment to other non-certified teaching or administrative applicants will be contingent upon a criminal history report that does not violate the requirements of Texas law or otherwise preclude employment or continued employment under discretion allowed to school districts under state and federal law. With the exception of certain criminal offenses that absolutely prohibit employment of any certified or non-certified person with a school district, other convictions will not necessarily disqualify an applicant from the job for which he or she has applied. However, such information may be taken into account in determining whether the conduct related to the conviction is reasonably related to the job for which the applicant has applied. All information provided by the employee or applicant shall be treated as confidential information. By the signing of this form you are agreeing to release, discharge and hold harmless the BISD and its employees and representatives as well as all organizations, agencies, corporations, partnerships, governmental entities, law enforcement agencies, individuals, employees and any other person or persons associated with the BISD from all actions, causes of action, claims, demands, liabilities for or by reason of the procuring or use of information provided to the BISD pursuant to the document.

Please provide the following information and responses: ________________________________________ Name (Printed) _______________________________________ Signature _______________________________________ Street Address _______________________________________ City, State and Zip Code _______________________________________ Driver’s license number including state _______________________________________ Social Security Number _______________________________________ Date of birth Sex (circle one):

Male

Female

Ethnicity (circle one):

Anglo

African-American

Asian

Hispanic

Other: ____________________

Rev. 09/2013

DPS Computerized Criminal History (CCH) Verification (AGENCY COPY)

I,

, have been notified that a computerized criminal APPLICANT or EMPLOYEE (Please print)

history (CCH) verification check will be performed by accessing the Texas Department of Public Safety Secure Website and will be based on name and DOB identifiers I supply. Because the name based information is not an exact search and only fingerprint record searches represent true identification to criminal history, the organization conducting the criminal history check for background screening is not allowed to discuss any criminal history record information obtained using the name and DOB method. Therefore the agency may request that I have a fingerprint search performed to clear any misidentification based on the name and DOB search. For the fingerprinting process I will be required to submit a full and complete set of my fingerprints for analysis through the Texas Department of Public Safety AFIS (Automated Fingerprint Identification System). I have been made aware that in order to complete this process I must make an appointment with MorphoTrustUSA, submit a full and complete set of my fingerprints, request a copy be sent to the agency listed below, and pay a fee of $24.95 to the fingerprinting services company, MorphoTrustUSA. Once this process is completed and the agency receives the data from DPS, the information on my fingerprint criminal history record may be discussed with me.

(This copy must remain on file by your agency. Required for future DPS Audits) ___________________________________ Signature of Applicant or Employee

Date

Boerne ISD Agency Name (Please print)

Agency Representative Name (Please print)

___________________________________ Signature of Agency Representative

Date

Please: Check and Initial each Applicable Space CCH Report Printed: YES

NO

initial

Purpose of CCH: Approved

Not Approved

initial

Date

initial

Destroyed

initial

Retain in your files Rev. 09/2013

Attention Substitute Teacher Applicants: Upon completion of a substitute application you will receive by mail on how to complete the fingerprint process. You will receive a FAST Pass that will need to be taken with you to the fingerprint location in San Antonio, New Braunfels, or Kerrville (there are other locations, but these are the closest). Once you received your FAST Pass, you will need to set up your appointment. Fingerprinting must be completed 14 days prior to training. The fee for the fingerprinting is $47.45 which is payable by check only at the fingerprinting location. If you are a certified teacher your fingerprinting information will be available at the SBEC (State Board for Educator Certification) website. Once fingerprinting is complete, you will need to provide us with the receipt or a copy of the receipt. If you have previously completed your fingerprinting, you will need to provide us proof of the fingerprinting. Once we have received your receipt, you will be notified of the next training session for substitutes. Employment forms will be sent to you for completion. These should be returned as soon as possible for processing. The training session format as follows: • Check –In Registration  • Training on legal issues by Mr. Craig Radtke, Director of Human Resources and Legal  Affairs  • Subfinder Training by Natalia Snyder  • Training on classroom instruction and management by Ms. Max Stumberg, District  Mentor  Allow 3-4 hrs. For the training session it will begin promptly at 1:00pm at the Central Office Board room. NOTE: Upon completion of the orientation and training all non-certified applicants will have to complete one half day of classroom observation prior to substituting. Pay Scales for Substitutes: • $70 a day‐ High School Diploma or its equivalent.  Associates degree or a full degree  from an accredited college.  • $80 a day‐ Hold a valid Teaching Certificate (Texas or other state, active or retired).  • $90 a day‐ Licensed nurse serving in a nursing assignment. Note: if you are a  registered nurse serving in a classroom assignment rate is $70 a day.  •

Certified teachers substituting in a long‐term teaching position will be paid at the  rate of $150/day.  A long‐term substituting position is one lasting 30 school days or  more as counted from the first day of substituting. This assignment will be approved  in advance by Human Resources. 

  Please contact Natalia Snyder at 830-357-2071 for questions or assistance.

Rev. 09/2013