PROFESSIONAL EMPLOYMENT APPLICATION Certified Personnel Only RHEA COUNTY PUBLIC SCHOOLS 305 California Ave. Dayton, Tennessee 37321 Telephone No. (423) 775-7813 FAX No. (423) 775-7831

Photograph Requested, but not Required

WE ARE AN EQUAL OPPORTUNITY EMPLOYER, PROSPECTIVE EMPLOYEES WILL RECEIVE CONSIDERATION WITHOUT DISCRIMINATION OF RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, OR HANDICAP. GRIEVANCE CONTACT PERSON: BILLY RAY PATTON (423) 775-7801

I. Name___________________________________________________________________________________________ Last

First

Middle Initial

Present Mailing Address____________________________________________________________________________ Street

City

State

Present Telephone Number______________________________________

Zip Code

Until__________________________

(Include Area Code)

Date

Permanent Address________________________________________________________________________________ Street

City

Telephone Number_______________________________

State

Zip

Social Security No.___________________________

(Include Area Code)

E-mail ___________________________*optional Birthdate__________________ Place of Birth________________________________ U.S. Citizen? Yes___ No___ Mo. Day

Year

City

County

State

II. Position Desired (List only those in which you are eligible for Certification) Elementary (List Preferred Grades)

Secondary (List Preferred Subjects)

Special Areas

1st Choice 2nd Choice 3rd Choice Date Available for Employment___________________________________________________________________ III. Educational Background (In order – beginning with High School) School

Location

Date Attended

Major

Minor

Degree Granted

Date Graduated

Diploma

High School (B.A.) College or University (M. A.) College or University Other(s)

Grade Point Average:

Overall_____________

Major Area_____________ (Optional – Not Required)

Areas of Certification in Tennessee_________________________________________________________________

________________________________________________________

IV. Student Teaching Internship (For applicants with less than three years experience) Name of School

Grades and/or Subjects Taught

Address

Dates

Critic Teacher

Military Service________________________ From________________ To _________________ Branch

V. Teaching Experience Name of School

Date

Date

(Regular, full-time only. Provide full address, including zip code.) List in order - beginning with most recent: Grades and/or Address Principal Subjects Taught Dates

Total Years

Last Annual Salary

Total Teaching Years________ VI. Other Work Experience. Type of Work

List in order – beginning with most recent: Name and Address of Firm or Employer

Dates of Employment

Last Annual Salary

VII. References: Name

Address (Include zip code and telephone no.)

Official Position

Include names of administrative and supervisory persons who have recently supervised your work. Applicants with fewer than three years of teaching should include college supervisor of student teaching as well as content area professor(s). Mark “Hold” in front of any reference you do not wish contacted at the present time. However, no employment commitment will be made until a contact is made with the current employer. It is your responsibility to have your college placement office send your reference and credentials. You must sign the Release of Information Statements before the references needed for employment consideration will be requested.

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VIII. Write a paragraph on why you have chosen teaching as a profession. Include any message or attitude you would like to have considered regarding possible employment. This paragraph, which is required of all applicants, must be in your own handwriting. It will be used to evaluate your use of the written language.

(If additional space is needed, continue on a separate sheet of paper and attach to this application.)

IX. Declaration: State law requires each person applying for a position with a school system to make the following declaration: 1. Have you ever been convicted of a misdemeanor or felony in Tennessee or any other state? Yes_____ No_____ (If yes, attach to this application a statement concerning convictions, fully explaining the details of each such conviction on a separate sheet of paper.) 2. Have you ever been dismissed from a position for incompetence, inefficiency, negligence of duty, unprofessional conduct or insubordination? Yes____ No____ (If yes, attach to this application a statement concerning each dismissal, place of employment, reason for dismissal and date of dismissal.) 3. Have or will you give notice to your present Board of Education 30 days prior to accepting employment with the Rhea County Public Schools? Yes_____ No_____ 4. Are you currently under contract? Yes_____ No_____ Contract period_________________________________ Who may be contacted regarding your contractual status? Title_________________________________ Name_____________________________________________________ Address________________________________________________________________Phone____________________ I,________________________________________ hereby certify that all statements contained in this application are true and complete. I understand that misrepresentation of any of these statements may subject me to the penalties described in Section 49-5-406 of the Tennessee Code. Signature________________________________________________________ Date______________________________

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INSTRUCTIONS TO APPLICANTS X. Your interest in Rhea County Public Schools is appreciated. To be considered for employment, all applicants for professional positions need to submit the following when applying for a position: 1. Original Professional Employment Application. It is important to complete all sections of the application accurately and neatly. 2. A copy of Transcript(s) showing degree(s). Applicants still in school should submit partial transcripts to be followed by complete transcripts when available. 3. A copy of PRAXIS (or as soon as available) showing you have passed the Content and Knowledge portion of your area of endorsement. 4. A copy of current Teaching Certificate, or as soon as available. 5. Reference forms (provided with this application). You have the choice of either confidential or nonconfidential references. Placement files from colleges may be added to applications. However, it is the responsibility of the applicant to request the file and to have reference form(s) completed and submitted. You may make copies of this form. 6. Interviews may be called for when the application has been on file two (2) weeks or longer. Applications being considered for employment will be required to interview with the appropriate supervisor(s), principals or other administrators who have vacancies. The following items are requested but are not required: 1. Recent Photograph 2. Career Ladder Test Scores XI. Upon employment with Rhea County Schools, ORIGINALS must be submitted of Transcripts, PRAXIS , and the original “Superintendent Copy” of your Teaching Certificate. XII. The Family Rights & Privacy Act of 1974 (PL93-380) permits a person to waive his or her right of access to confidential recommendation statements obtained with respect to an application for employment. Release of Information Statement: I hereby authorize the release of all application data needed for employment by authorized personnel of the Rhea County Public Schools. I further waive my right to read materials entered in my file for employment decisions. I understand my file is confidential. _______________________________________________ Signed ________________________________________________________________

Date All correspondence should be addressed to:

Rhea County Department of Education 305 California Avenue Dayton, TN 37321 Telephone: (423) 775-7813 FAX: (423) 775-7831

XIII. Applications are kept on active file for one (1) year. An applicant may make a request in writing if he/she wishes his/her application to remain active for a second year. All documents filed herewith (except Certificate) become the property of this Board of Education.

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CONFIDENTIAL RECOMMENDATION ____________________________________________________________________________________________________________________

Student’s Full Name

Degree & Major

Date of Graduation

I waive my right of access to this form.

I do not waive my right of access to this form.

______________________________________________ Signature Date

_______________________________________________ Signature Date

Definition of traits under consideration: Excellent: Good: Average: Fair:

Consistently demonstrates high degree of achievement, seldom exceeded by peers. Generally performs above peers. No better or worse than peers. Seems to lack the particular trait or demonstrates it less than peers.

WORK PERFORMANCE ORIGINALITY

TRAITS Excel. Good Performs work promptly, independently, thoroughly; industrious Imaginative, not stereotyped in thinking;

Avg.

Fair

Not Observed

resourceful; shows initiative JUDGEMENT WRITTEN EXPRESSION ORAL EXPRESSION PROFESSIONAL DEVELOPMENT LEADERSHIP

Critically evaluates facts in reliable manner; uses common sense Objective, logical, clear Clear, friendly, objective, logical

MATURITY

Capacity for personal and professional development Capacity to assume responsibility, organize work and work through others Ability to evaluate new or changing conditions and accept them naturally Sociable, pleasant, makes good impression on others Stable, dependable, adult in attitudes

PERSONAL CONDUCT PERSONAL APPEARANCE

Good manners, courteous, considers feelings of others Well groomed, neat, orderly in dress and appearance

ADAPTABILITY PERSONALITY

How well do you know this person? (Check one)

Not at all_____ Slightly_____ Fairly Well_____ Very Well_____

Explain:_____________________________________________________________________________________________

_____________________________________________________________________ Additional Comments:_________________________________________________________________________________

_____________________________________________________________________ _____________________________________________________________________ Evaluator’s Signature

Title and Department

Please Return this form to: Rhea County Department of Education, 305 California Ave., Dayton, TN 37321 Phone: (423) 775-7813

Date

FAX: (423) 775-7831

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