Missin The Primer RE-2 Schl District shall strive t prvide a safe envirnment, fr all students and staff and meaningful pprtunities and innvative educatinal prgrams fr all students s that they reach their learning ptential, including that they meet r exceed state and district cntent standards thrugh partnerships between hme, schl and the cmmunity. Page 1 f 5
Persnal Infrmatin PRIMERO RE-2 SCHOOL DISTRICT Name Last First Middle Hme Address Telephne City State Zip Business Address Telephne City State Zip Email Address **All crrespndence will be sent t the abve email address unless yu request therwise** Present Psitin Please respnd t each item. If yu are nt currently emplyed in a public schl psitin, list yur current psitin, nt the mst recent schl psitin and prvide as cmplete infrmatin as pssible. Are yu presently emplyed? N Title Since Emplying District Address Street City State Zip Ttal pupils enrlled Number f licensed staff Number f classified staff Current salary Number f elementary schls Number f middle schls Number f high schls Benefits and apprx values Length f current cntract Expiratin date Date available Reasn fr leaving present psitin Immediate supervisr Business Telephne Hme telephne What administratr licenses d yu hld? Page 2 f 5
References Please list cntact infrmatin fr three persnal references Name Organizatin Address Telephne Backgrund Check In additin t the fllwing infrmatin, a thrugh backgrund check will be cnducted as required by state law. Have yu been cnvicted f a felny, pleaded n cntendere r received a deferred sentence r prbatin fr any ffense invlving mral turpitude? (Mral turpitude includes, but is nt limited t such ffenses as theft, attempted theft, murder, rape, embezzlement and indecency with a minr.) N If yes, state the nature f the ffense, date f cnvictin, name/address f the curt and ther pertinent details.* *Cnvictin f a crime is nt an autmatic bar t emplyment. The district will cnsider the nature f the ffense, date f the ffense and relatinship between the ffense and the psitin fr which yu are applying. Have yu ever been invluntarily terminated r asked t resign frm the emplyment f anther schl district? N If yes, please give the name f the district, the date and the reasn fr the terminatin r request fr resignatin. Have yu ever reached a mutual decisin with an emplying schl bard t vacate a cntract prir t its expiratin? N If yes, please explain Page 3 f 5
Are yu aware f any reasn why yu wuld nt be able t perfrm the duties required f the psitin fr which yu are making an applicatin? N If yes, please explain Required Resume, Reference Letters and Narrative Items Please include a current resume and three letters f references that have been written within the last tw years. Please answer the fllwing essay questins n separate pages, each n lnger than ne typed page in length. 1. Explain hw yu have wrked t build relatinships and cnsensus amng grups f peple and give specific examples. 2. As a superintendent, hw wuld yu develp and nurture a successful wrking relatinship with the schl bard, staff and cmmunity members in ur district? 3. Discuss yur beliefs abut small cmmunities, their values, the challenges f small schl districts and why yu chse t be part f this envirnment. State Requirements and Infrmatin Candidates must be able t perfrm the essential functins f the psitin. The Bard f Educatin may require, at its wn expense, a cmplete physical examinatin nce a cnditinal ffer f emplyment is made. This applicatin and all assciated dcuments will remain cnfidential t the extent allwed by Clrad law. Nte: Clrad Public Recrds law allws applicants t remain cnfidential, until such time as the applicant becmes a finalist fr the psitin. An effrt will be made t ntify thse applicants prir t designating finalists fr the psitin. When an applicant becmes a finalist, all recrds becme available t public inspectin with the exceptin f letters f reference r medical, psychlgical and scilgical data. The Primer RE-2 Schl District ffice must receive a cmplete applicatin by 12:00 nn March 8, 2013. Applicatin materials received after this date/time will nt be cnsidered. A cmplete applicatin includes the fllwing: Letter f interest fr the psitin Cmpleted and signed applicatin including answers t essay questins Current prfessinal resume Academic transcripts frm cllege/university Clrad license Three recent (dated within the past tw years) letters f recmmendatin Page 4 f 5
Address applicatin materials and cmmunicatins t: Michael Duran Schl Bard President r Tina East District Secretary 20200 State Highway 12 Westn, CO 81091 Fr mre infrmatin call: 719-868-2715 r visit the schl website at www.primerschl.rg N faxes please Equal Opprtunity Emplyer Primer RE-2 Schl District is an equal pprtunity emplyer and all applicatins are cnsidered withut regard t race, clr, sex, religin, natinal rigin, ancestry, creed, age, marital status, sexual rientatin, genetic infrmatin r disability. Agreement I hereby certify that all statements made n this applicatin are true, accurate and cmplete. Any misrepresentatin r willful missins f facts shall be sufficient cause fr disqualificatin f the applicatin r terminatin f emplyment. I hereby authrize the district r its agents t cnduct wrk histry and persnal reference checks t verify statements n this applicatin frm and ther materials prvided as part f my applicatin fr this psitin. Signature Date Page 5 f 5