Employee Application. Personal Information

Transcription

1 Employee Application Submit your cover letter and application to Alpharetta Highway, Suite 146, Alpharetta, GA If applying for a teaching position, please include a copy of your diploma and/or teaching certificate. Confirmation of submission will be sent to the address provided on your application form. Full Name: Personal Information Last First M.I. Street Address Apartment/Unit # Home Phone: ( ) Alternate Phone: ( ) Social Security Number or Government ID: Birth Date: Spouse s Name: Spouse s Employer: Spouse s Work Phone: ( ) Institution 1: Institution 2: Degree: Major: Degree: Major: Professional Certificates & Honors: Education Date Received: Minor: Date Received: Minor: Work Experience Employer 1: Employer 2:

2 Work Experience (continued) Employer 3: Professional References Name: Organization: Title: Name: Organization: Title: Emergency Contact Information Full Name: Last First M.I. Street Address Apartment/Unit # City State ZIP Code Phone: ( ) Cell Phone: ( ) Relationship: I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above. Signature Date

3 Questions Briefly describe your understanding of who Jesus Christ is. Describe your personal relationship with Jesus Christ. What would you do to build positive, Christ-like attitudes in your students? Denominational preference Church Name Pastor Address Member how long? Is active church membership necessary for spiritual growth? Please explain. A teacher cannot ensure a student s success. We can encourage, enhance, provide avenues for successful learning, but we cannot guarantee it. What does success in learning mean to you? Is education more about experience and process or subject matter and content? Explain. What procedures do you use to evaluate student progress besides using tests? Why will students want to come to your classroom everyday? Has an investigation been conducted or was an investigation pending at the time of separation from your previous employer? Yes No

4 Legacy Statement of Faith and Christian Worldview \ Yes No Yes No

5 Authorization for Background Check Please read and sign this form in the space provided below. Your written authorization is necessary for completion of the application process. I,, hereby authorize Legacy Community Academy to investigate my background and qualifications for purposes of evaluating whether I am qualified for the position for which I am applying. I understand that Legacy will utilize an outside firm or firms to assist it in checking such information, and I specifically authorize such an investigation by information services and outside entities of the company's choice. I also understand that I may withhold my permission and that in such a case, no investigation will be done, and my application for employment will not be processed further. Notice of Intent to Procure Consumer Report (Background Check) Pursuant to the Fair Credit Reporting Act, 15 U.S.C. Section 1681 et seq., this notice is to inform you that as part of our evaluation procedure for employment, promotion or retention, we may obtain and review consumer report(s) and/or investigative consumer report(s) for employment purposes concerning you (Background Check). These report(s) will be obtained through the following Consumer Reporting Agency: Amerisearch Background Alliance, 2529 South Ridge Rd E; Phone: (800) Driving history records (DMV/MVR) will be obtained through First Advantage ADR. You have the right to make a written request, within a reasonable period of time after receiving this notice, for additional disclosures as to the nature and scope of any consumer report(s) we obtain. You are also entitled to receive a copy of the Federal Trade Commission s publication, A Summary of Your Rights under the Fair Credit Reporting Act. You may have additional rights under state law. By signing below, I authorize Amerisearch Background Alliance, to conduct an employment-related background check on me and to provide the results to the employer named below. I understand this report may contain information as to my character, general reputation, personal characteristics, or mode of living, such as my work habits, work performance and experience, reasons for discipline or termination from any current or prior employment, history of earnings, credit worthiness, credit standing or credit capacity, criminal convictions, driving history, and other related matters that may concern my eligibility for the position or promotion I am seeking Amerisearch Background Alliance, will not provide any information where such disclosure is restricted by federal or state law. By signing below, I authorize any present or past employer, supervisor or agent of the employer; high school, college, university or other institution of learning; local, state or federal court; department of motor vehicles, military branch or the national personnel records center; state sex offender registry, state licensing board, state workers compensation agency, credit bureau, personal or professional reference; to release records or information to Amerisearch Background Alliance, concerning my name, criminal history, motor vehicle history, social security number, earnings history, credit file, address history, educational history, character, reputation, and employment (including documented reasons for termination or discipline) and release such from any and all liability for any damage that may result from the furnishing of this information. This authorization shall be valid in original, faxed or photocopied form. This authorization shall expire upon termination of my employment with the employer named below. Report to be released to: Applicant Name Any other names used for employment or education Applicant City/State/ Zip Code Social Security Number: Driver s License Number Month/Day of Birth/Year State Issued : May we contact your current employer?! Yes! No! Not Currently Employed Signature of Employee Employee's Name Printed Date