Sheffield-Sheffield Lake City Schools

Green Local Schools 4070 Gallia Pike Franklin Furnace, OH 45629 Voice: (740) 354-9221 FAX: (740) 355-8975 Certified/Administrative An Equal Opportunity Employer Email: [email protected] Application

Name (Last, First, Middle) Social Security Number Date

a Permanent Address Home Phone Business Phone t ( ) ( ) a D

l City State Zip Place of Current Employment a n o

s Present Address (if Different than above) Name & Phone of Person to help us make contact with you r e P City State

Check Position Applying for Substitute Teacher Administrator Tutor Other:

Date Available for the Green Local School District: List any activities that you are willing to direct (Athletic Teams, School Clubs, Yearbook, etc.) n o i t Date of Certificate Subjects and/or Grade Levels on

a Name of Ohio Teaching License(s) you hold Date of Issue Expiration Number Certificate c i f i t r e C

l a n o i t a c u d E

Location Semester School Dates Attended Degree Major/Minor City, State Hours y r

o Elementary t s i H

High School l a n o

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Other Work Experience Additional Background Teaching Experience TeachingStudent for the Green Local Schools Local the Green for Have you ever served in the U. S. Armed Forces? Armed ever U. inS. Have you the served thata been haveworks everforinterview for,relative or Have you applied List other experiences that will help you as a professionalexperiences awillyou educator.otheras that help List position? resign everteaching dischargedrequested to from a Have you or been continuingcontract Ohio?everaemployed under in Have you been contract? you under presently Are List all contracted positions you have held as a certified teacher. List most recent experience first. In Ohio, 120 or more days under aunder 120more teaching days first. Ohio,or In mostexperience teacher. List asrecent certified held allpositions you a have List contracted School Name School Work and/or Experienceand/or Work Address Address School No No Subjects Subjects &Taught Grades contract in the same school year equals one experience.ofschoolyearsame inequals one year contract the Yes, If yes what district:yes Yes, If Phone Home & Home Work Phone No Name of Principalof Name Yes, If yes what Branch (Rank and Dates) andIf (Rank what Branch yes Yes, W H W H W H W H W H No No Duties

Yes, If yes what district:yes Yes, If Relative, Who: Date:Application, Interview, Date: Cooperating Cooperating Teacher No Subjects Subjects Taught Yes, If yes what district and givean explanation:andIf what district yes Yes, W H W H From Home and Work andHome Phone Dates Dates To Total YearsTotal Completed Dates

Personal Reflections on Education Legal Information What do you want to accomplish as a you teacher?want accomplishto a as do What answers encouraged. are concise Brief, spacein profession. theprovided. item respondthePlease each experiencesto youreducation with of somethoughts about us and share Please you anotherwork ever under name? Did felony? ever convicted aof Have you been thisofbe yeardated it a date. mustwithin application Investigations, Criminal the Bureau haveof If letter from a yourecords check. positioninmustcriminal seriouslyconsidered whoarea Green complete All for Applicants Describe your disciplineDescribe your plan class?yourdo you in decide what teach to How date.careerto teachingyour most in significant event Describe the special you characteristicsmake teacher.a that the List employer?we present contact your May No Yes No Yes, If yes explain and provideIf andexplain yes dates: Yes, No, If no explain: If No, Yes, If explain: yes Yes, It is the policy of the Green Local Board of Education, that the best qualified applicant shall be selected for each position without regard to race, color, religion,race,color,to shallselected regard qualifiedfor position without theapplicant each best be Education, that of BoardpolicyGreen Local is the the of It Applicants Statement Personal Reflections on Education Title IX TitleCoordinator: IX Signature of Applicantof Signature Office. Superintendent’s inbe courseson file the andmust credits college of transcript before employment can complete begin, a thatfurther and eligibilityunderstand of certification. Iplacement evidence references for Office, filethehave Superintendent’s inmust on employment, I understandbefore final consideration for consequence, that aI States. As the work United in to aliens, or, legal their authorization identitycitizen status if their U.S. certain and verify conditiondocumentation to a employment produce of as must,individual law understandaccording federal all to hired hired. who are that I event job inam beingconsideredany future Ithe which amor for theperform tojob abilitywhich determine my releasebe to tohospitalnecessary authorize anymayIany orinformation physician further information. supplying districtscorporationssuch from or alland orsuch releaseresponsibility requesting investigation, liabilitypersons, schooland in activities. Icooperate employment and to agree past my authorizethorough investigation of a ata dismissal date. I later if justification for discovered employmentandbe consideredconsideration for disqualify may from information orfurther any significant omissions may falsified me that alsoagree I best knowledge. my andof accompanying thisresume) the to complete the (and application affirmis true information on hereby that I doingmost?do you freetime,youenjoy have what When continuedQuestions Describe the role of the parent in your plan.parent inrole educational the Describe theof babysitters? highlyteachers are thatpaidchallengedo you allrespond the Howto plan? technology do into educationalyouyour incorporateHow handle whoisacademicallychild youpoorly.Describe how a wouldperforming national origin, age, sex or marital status. If you need assistance because of any special circumstance, call the Board of Education office. call Education office. circumstance,theof Board you any need of special assistance maritalIfbecause status. nationalor origin, sex age, Amanda Sherman, High School Guidance Counselor Guidance Amanda School Sherman, High -

4057 Gallia Furnace, 4057 Pike, Franklin Date Ohio 45629 740-354-915045629 x3503 Ohio