Alva Public Schools

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CERTIFIED TEACHING APPLICATION COMPLETED ONLINE

CERTIFIED STAFF
APPLICATION FOR INSTRUCTIONAL STAFF POSITION

All applicants for teaching, counseling or administration positions at Alva Public Schools must complete this application.

The Alva Public Schools does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups. The following persons have been designated to handle inquiries regarding the non-discrimination policies:
Coordinator for Section 504/Title II (for questions or concerns involving students, patrons, employees and other adults) - Superintendent, Alva Public Schools, 418 Flynn Street, Alva, OK 73717; (580) 327-4823 | email: schools@alvaschools.net.

Coordinator for Title VI (for questions or complaints based on race, color and national origin), Title IX (for questions or complaints based on sex), and Age Act (for questions or complaints based on age) - Superintendent, Alva Public Schools, 418 Flynn Street, Alva, OK 73717; (580) 327-4823 |email: schools@alvaschools.net.

For further information on notice of non-discrimination, visit for the address and phone number of the office that serves your area, or call 1-800-421-3481.

Please Fill Out The CERTIFIED TEACHING APPLICATION COMPLETED ONLINE Below

Resume

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Date:

Last Name, First Name, MI

Address

City

State

Zip

Certification #

Expiration Date:

Home Phone Number

Work Phone Number

Position Applied For

Early Childhood K-2

Elementary Grades 1-5

Junior High School Grades 6-8

Subject(s)

High School Grades 9-12

Subject(s)

Administrator(Elementary)

Administrator(Secondary)

Counselor

Library-Media

Special Education

References: List the name of four references capable of giving information about your teaching and preparation for teaching. List at least one administrator for each of your teaching positions.

Full Name of Reference

Position

School Name and Address

Phone

Full Name of Reference

Position

School Name and Address

Phone

Full Name of Reference

Position

School Name and Address

Phone

Full Name of Reference

Position

School Name and Address

Phone

High School Attended

Mailing Address

Year Graduated:

College or University Attended

Major Field of Study

Minor Field of Study

Type of Degree

Year Earned

Extra Curricular Activities You Can Direct

Reaquired field: Yearbook

Reaquired field: Newspaper

Reaquired field: Cheerleading

Reaquired field: Coaching

Reaquired field: Other

Teaching Experience: List in chronological order.

From

Number of Years

Name and Address of School

Principal or Supervisor

Grade or Subject Taught

From

Number of Years

Name and Address of School

Principal or Supervisor

Grade or Subject Taught

From

Number of Years

Name and Address of School

Principal or Supervisor

Grade or Subject Taught

From

Number of Years

Name and Address of School

Principal or Supervisor

Grade or Subject Taught

From

Number of Years

Name and Address of School

Principal or Supervisor

Grade or Subject Taught

Are you willing to accept any assignment for the good of the school system, attend meetings or participate in other activities outside of school hours or Saturday mornings?

Have you ever failed to be reemployed?

Where?

If yes, please explain

Why do you wish to leave your present position?

On what date will you be available if offered employment at School Name?

Have you ever entered a plea of guilty or nolo contendre to a state (any state) or federal charge? (This question includes criminal cases involving a deferred sentence, deferred judgement, and any expunge of the records)

Reaquired field: Yes

Reaquired field: No

Have you ever been convicted of a state (any state) or federal felony offense?

Reaquired field: Yes

Reaquired field: No

Have you ever been charged with a state (any state) or federal felony offense, which was reduced to a misdeameanor offense to which you enterd a plea of guilty or nolo contendre? (This questions includes criminal cases involving a deffered sentence, deffered judgement, and any expunge of records.)

Reaquired field: Yes

Reaquired field: No

Have you ever entered a plea of guilty or nolo contendre to, or been convicted of a state (any state) or federal misdemeanor charge involving illegal chemical substance or illegal sexual activity? (This question includes criminal cases involving a deferred sentence, deferred judgement, and any expunge of the records.)

Reaquired field: Yes

Reaquired field: No

Have you ever entered into a deferred prosectution agreement with a state (any state) or federal prosecutor?

Reaquired field: Yes

Reaquired field: No

Have you ever been required to register as a sex offender under the Oklahoma Sex Offender Registration Act or under similar laws in another state?

Reaquired field: Yes

Reaquired field: No

I understand that my application will remain active for one year and that I should notify Alva Public, in writing, if I wish to be considered beyond that period. All persons, firms, and entities listed in this application are hereby authorized to release any information or records concerning me to the personnel department of "School Name" and I hereby release said persons, firms, and entities from any liability as a result of the furnishing of such records and information. I certify to the best of my knowledge the facts set forth in my application are accurate and complete. I understand that falsifying information on this application will result in non-employment or, after employment may result in discharge.

Signature (By typing your name, you agree that this is valid as your signature.)

Date

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Required Fields

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