Waterville Public Schools

KENNEBEC VALLEY CONSOLIDATED SCHOOLS AOS #92 {Vassalboro, Waterville, Winslow} Office of the Superintendent 25 Messalonskee Ave. Waterville, ME 04901 (207) 873-4281 Visit our school web page: www.aos92.org

SECRETARIAL APPLICATION

Fingerprinting will be necessary in order to be employed – schedule on line at: www.identogo.com or call 1-855-667-7422. Augusta Certification Office number: 207- 624-6603

THE KVCS DOES NOT DISCRIMINATE IN THE OPERATION OF ITS EDUCATIONAL AND EMPLOYMENT POLICIES AND WILL HONOR ALL APPROPRIATE LAWS RELATIVE TO DISCRIMINATION.

Date______Position(s) applying for:

Name______Social Security ______No.______When will you be available? ______Permanent Address______Phone/Cell Phone:______Email Address:______

How did you find out about this job (please circle)? Newspaper, Internet, Friend, Other______

EXPERIENCE: A resume must be provided. In addition to educational background and work experience, include computer programs that you are proficient with.

Have you ever been disciplined, discharged, or asked to resign from a prior position? If Yes____ No____ yes, explain the circumstances on a separate sheet and attach it to this application.

Have you ever been charged with or investigated for sexual abuse of another person? Yes____ No____

Have you ever been charged with, pleaded guilty or “no contest” (nolo contendere) to, or Yes____ No____ been convicted of any crime involving sexual abuse of any person or any other crime or moral turpitude?

Have you (a) ever been convicted of a crime, other than a minor traffic offense; or (b) ever Yes____ No____ entered a plea of guilty or a plea of “no contest” (nolo contendere), or has any court ever deferred further proceedings without entering a finding of guilty and placed you on probation, for any crime other than a minor traffic offense?

If you answered YES to any one of the previous questions, please explain, in detail, including the date of the court action, the offense in question, and the address of the court involved: ______Note: Conviction of a crime is not an automatic bar to employment by the school unit.

(Over) REFERENCES: List three (two of whom are your most recent supervisors) who can comment on your ability and whom we may contact.

Name Position Address Phone FAX

______

Any falsification of information or misleading information on this application shall be fully sufficient grounds to refuse to employ or, having been employed, shall be immediate cause for dismissal.

My signature below constitutes authorization to check my employment history, including without limitation, criminal arrest and conviction record checks, reference checks, and release of investigatory information possessed by any state, local or federal agency. I further authorize those persons, agencies or entities that the KVCS-AOS #92 contacts in connection with my employment application to fully provide the KVCS-AOS #92 any information on the matters set forth above. I expressly waive in connection with any request for or provision of such information, any claims, including without limitation, defamation, emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against the KVCS-AOS #92, its agents and officials or against any provider of such information.

I understand that information submitted in and with this application may be disclosed to a screening and/or interviewing committee, which may include board members, administrators, other staff, and members of the community. I give my consent to this disclosure.

______Signature

Notice: Applications will be retained for a period of 12 months from date of receipt. All materials become the property of the KVCS-AOS #92. None will be returned.

The School Boards of AOS #92 are Equal Opportunity Employers