Please enable JavaScript in your browser to complete this form.EMPLOYMENT APPLICATION 2022-23 School YearThis is an Employment Application for potential employment with an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religion, marital status, disability or any other characteristic protected by applicable federal, state, or local law.Last Name: *Middle Initial: *First Name: *Mailing Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeTelephoneHome:Cellular: *Alternate:Email *Are you 18 years of age or older? *Choice 4YesNoPOSITION/ AREA OF INTERESTPosition(s) of Interest (Select all that apply) *TeacherLead TeacherParaprofessionalElective Teacher (specify below)Other (specify below)Elective Content Area(s)Other Content Area(s)EDUCATIONHighest Level of Education *High SchoolVocational/Trade SchoolCollege/University(s)Graduate SchoolHigh School #1High School (Name/ Address) (1)Date / Years of Completion (1)Degree/ Diploma Earned (1)High School #2High School (Name/ Address) (2)Date / Years of Completion (2)Degree/ Diploma Earned (2)College, Business/ Trade School #1College, Business/ Trade School (Name/ Address) (1)Date / Year of Completion (1)Degree/ Diploma Earned (1)College, Business/ Trade School #2College, Business/ Trade School (Name/ Address) (2)Date / Year of Completion (2)Degree/ Diploma Earned (2)College, Business/ Trade School #3College, Business/ Trade School (Name/ Address) (3)Date / Year of Completion (3)Degree/ Diploma Earned (3)Educational/ Administrative/ Trade Licenses or Certificates #1Type of License/ Certificate (1)State Issued (1)Endorsement / Level/ Type (1)Date Issued (1)Date of Expiration (1)Educational/ Administrative/ Trade Licenses or Certificates #2Type of License/ Certificate (2)State Issued (2)Endorsement / Level/ Type (2)Date Issued (2)Date of Expiration (2)WORK EXPERIENCECompany #1 (Name/Address/Phone) *Company #1- Position Held *Company #1- Supervisor *Company #1- Start/End Date *Company #1- Hourly/Annual Salary *Company #1- Reason for Leaving *Company #1- List job duties performed, skills used/ learned. *Company #2 (Name/Address/Phone)Company #2- Position HeldCompany #2- SupervisorCompany #2- Start/End DateCompany #2- Hourly/Annual SalaryCompany #2- Reason for LeavingCompany #2- List job duties performed, skills used/ learned.Company #3 (Name/Address/Phone)Company #3- Position HeldCompany #3- SupervisorCompany #3- Start/End DateCompany #3- Hourly/Annual SalaryCompany #3- Reason for LeavingCompany #3- List job duties performed, skills used/ learned.List skills/ experience that qualify you for this application's position.Detail evidence of student achievement. (attach supporting documentation)ADDITIONAL INFORMATIONHave you ever worked for Linwood Public Charter School? *YesNoIf Yes, please list dates and position held:Have you ever been convicted of, or entered a plea of guilty to a criminal offense? *YesNoIf Yes, please explain:If hired, can you furnish proof that you are eligible to work in the United States? *YesNoIf No, please explain:Referred By?REFERENCESPlease include name, phone number, and circumstances of your acquaintance. Exclude relatives and former employers.Reference #1- Name *Reference #1- Phone *Reference #1- Circumstances of your acquaintance *Reference #2- Name *Reference #2- Phone *Reference #2- Circumstances of your acquaintance *Reference #3- Name *Reference #3- Phone *Reference #3- Circumstances of your acquaintance *Resume (Required); Supporting documentation (Optional) * Click or drag a file to this area to upload. APPLICATION AND E-SIGNATURE DISCLOSURE AGREEMENTOnline Application and E-Signature Agreement: I understand that I may be required to provide a set of fingerprint impressions and that a criminal background check must be conducted and satisfactorily completed if I consideration for employment as a precondition of my employment, if hired. I understand that investigative background inquiries may be made on me including previous employers, schools, consumer credit, criminal convictions, motor vehicle, and other reports. These reports may include information as to my character, work habits, performance, education, compensation, and experience along with reasons for termination of employment from previous employers. I hereby authorize contact with my former and current employers, educational institutions, and references I have provided regarding me and my performance record, work, experience. I also hereby release Linwood Public Charter School and its employees and agents, and all of my previous and current employers, educational institutions, and references I have provided from any and all liability and damages for releasing, in good faith, or using information concerning me and my performance record, work, and experience. I also hereby waive any right I may have under local, state, or federal low to receive written notice from the organization to which I am applying or any previous or current employer that disciplinary reports, letters of reprimand, or other disciplinary action taken against me while employed will be or have been disclosed to a third person or entity. I am aware that all hiring and employment is at will. I understand that this application is not an employment contract, nor can it be used to create one. Employment by Linwood Public Charter School has no specific term and may be terminated by me or this organization with or without notice. I acknowledge that the organization has not made any promises or representations that differ from those contained in this paragraph. I understand that I must provide satisfactory documents to establish my identity and right to work in the United States, if I am offered a positon, and that failure to provide this evidence may result in the termination of my employment, if hired. I release and agree to hold harmless any individual, company, business institution or government agency from all liability with regard to furnishing information to this organization. I agree to release and hold harmless this organization and those affiliated with it from liability with respect to receipt of such information. I certify that the information I have furnished on this employment application form and accompanying documentation, including my resume, is true and complete, and I understand that any false information or misleading information or significant omissions made verbally or in writing my disqualify me from further consideration for employment and may lead to my dismissal from employment, if discovered at a later date. I agree to immediately notify the organization to which I am applying if I should be convicted of a felony, or any crime involving dishonest or a breach of trust while my job application is pending, or during my period of employment, if hired. By typing in your legal name below, you are signing this application electronically. You give your electronic signature the power to be the legal equivalent of your manual signature on this application. You further agree that your use of a keypad, mouse or other device to select an item, button, icon or similar act/action, or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature.Signature *Date *MessageSubmit