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Certified Teacher Application

MEDICINE LAKE PUBLIC SCHOOLS
P.O. BOX 265
MEDICINE LAKE, MT 59247
406-789-2211

Certified Teacher Application

Certified Teacher Application

PERSONAL INFORMATION

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Min: 1 Max: 5
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POSITION INFORMATION

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EDUCATION

Education and Professional Training-please list in reverse order of attendance (most recent institution first) all educational institutions attended. CERTIFIED STAFF-Information provided should be complete, as it will be used as a preliminary basis for determining salary. Attach additional sheets if necessary.


Institution #1 (most recent):

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Institution #2

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Institution #3

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Institution #4

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Additional education information can be uploaded at the end of this application.

CERTIFICATION AND ELIGIBILITY INFORMATION:


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PLEASE ANSWER THE FOLLOWING QUESTIONS





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EMPLOYMENT RECORD

List your present or most recent employer. Describe your employment history, accounting for all time during at least the last 10 years. You may include volunteer and paid experience. DO NOT substitute a resume. You may attach additional information.


Employment #1 (most recent)

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Employer #2

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Employer #3

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Employer #4

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Employer #5

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Employer #6

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Employer #7

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Additional employment information can be uploaded at the end of this application.

EXTRACURRICULAR INTERESTS

Please indicate which you have experience and/or ability to assist in an extracurricular program. This includes such areas as: Music, Speech/Drama, Publications, and Athletics. List the specific activities, not just the area for which you are qualified and are willing to direct.


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REFERENCES

Please list current information of three persons not related to you and whom you have known for at least one year, who have not previously been listed on a resume, and who have knowledge of your educational background.


Reference #1

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Min: 1 Max: 5
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Reference #2

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Min: 1 Max: 5
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Reference #3

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Min: 1 Max: 5
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Equal Opportunity Employer

Medicine Lake School District #7 prohibits discrimination against or harassment of any person employed by or seeking employment with the school district because of race, creed, religion, color, political affiliation or national origin or because of age, physical or mental disability, marital status, or gender when the reasonable demands of the position do not require an age, physical or mental disability, marital status, or gender distinction. People of disability may request reasonable accommodation in the hiring process by contacting the school district personnel office.


Proof of Employability

Any applicant chosen for employment must be able to produce a social security card, driver's license, or some other acceptable form of verification of employment eligibility in the United States pursuant to Form I-9 of the U.S. Department of Justice.


Authorization to Relase Employment Records

If employed by a participating school district, the applicant authorizes the school district to supply his/her employment record at the school district's sole discretion, in whole or part, to any prospective employer, government agency, or other party, when the school district's interest is deemed appropriate.


Drug Free/Tobacco Free Policies

Medicine Lake School Districts are drug free, tobacco free schools and, as such, require all employees to adhere to specific drug free, tobacco free policies.


Acknowledgement

I understand that no offer of employment or benefits, such as, but not limited to, a pension plan, insurance, vacation, or salary rate, is final until it has been reviewed by the District Administration, satisfactory completion of a fingerprint background check is made (This may take as long as 3-4 weeks after submittal of the fingerprints to the Administration Office.), and until fully approved by the Board of Trustees or designated authorized representative. I understand that no contract for employment shall be issued until all of the above items are complete. Further, I have read and understand the above policies of employment. Further, I have read and understand the above policies of employment.


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PLEASE READ THIS SECTION BEFORE SIGNING

THIS APPLICATION IS NOT A CONTRACT OR OFFER OF EMPLOYMENT.

I understand any false statements or misrepresentation of facts are grounds for dismissal or removal of consideration for employment. I hereby declare that the statements above are true, correct and complete to the best of my knowledge and belief. I waive the right to hold liable those persons whose names appear on the application form. I understand that omission or misrepresentation of material fact may result in refusal of or suspension from employment. I hereby authorize Medicine Lake School District #7 to obtain investigative reports, which may include information as to my character, general reputation, personal characteristics, criminal records, and lifestyle, as well as all statements included in this application. I agree to hold this School District and it's employees, as well as my previous employers and professional references, harmless to any information provided.


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