Date of Application:

PERSONAL INFORMATION

Applicant's Name Last First Middle

Current Address Street City State Zip

Permanent Address (If different) Street City State Zip

Home Phone # ( ) Business Phone # ( )

Cell Phone # ( ) Email Address

Social Security # Place of Birth

Religion If Catholic, practicing Catholic? Yes No

Church Parish Citizenship: United States Other

EMPLOYMENT PREFERENCE(S)

I would like to apply for the following position(s). (Please check all that apply.)

Full Time Teacher List Subject Area Extracurricular Preference(s) Librarian 1st Preference Part Time Counselor 2nd Preference Campus Minister Substitute Administrator Present Salary $ Other ______Expected Salary $

Indicate the length of time you plan to teach.

Date available for employment

TEACHING CERTIFICATE(S)

Active Class & Type Date Date of Subjects and Grades for State Yes or No of Certificate Issued Expiration Certificate # which you are certified

EDUCATIONAL BACKGROUND

Name of School City, State # Years attended Date of Graduation Elementary School(s)

High School(s)

Dates attended 1. School From To 2. City, State (Mo., Yr.) (Mo., Yr.) Degree earned Major Minor Colleges / 1. Universities 2.

1. 2.

1. 2.

1. 2.

If you have not completed undergraduate studies, indicate the pending date for receipt of your degree.______

Total credits earned to date in Education courses

List the subject area(s) in which you are not certified, but have earned at least twelve semester hours credit.

Indicate your graduate / post-graduate study plans.

List foreign language(s) with which you have a speaking or reading facility, and indicate your degree of proficiency in each.

TEACHING EXPERIENCE(S)

List your employment experiences in the field of education in chronological order (beginning with your most recent position)

Type of Position, Period of Service i.e. Teacher, 1. School From To Prin., Supt., etc. 2. School District, City, State Grade(s) Subject(s) (Mo., Yr.) (Mo., Yr.) 1. 2.

1. 2.

1. 2.

1. 2.

1. 2.

Total years of FULL-TIME teaching experience: Elementary (Grades PK-6) High School (7-12) How many days were you absent from work during the past twelve months?

Yes No Have you ever failed to be re-employed? ...... Have you ever failed or refused to fulfill an employment contract with any school? ...... Have you ever been arrested for other than a minor traffic violation? ...... Have you ever been found guilty of immoral conduct or dismissed from any teaching position for immoral conduct or unprofessional conduct or unfitness for service? ...... Have you ever been convicted of or pled ‘nolo contendere’ to a crime? ...... (If you answered ‘yes’ to any of the questions above, provide details, on a separate sheet of paper.) Can you perform the essential functions of the job for which you are applying? ......

WORK EXPERIENCE(S) (Non-Educational)

List your employment experiences outside the field of education in chronological order (beginning with your most recent position) Periods of unemployment, and reasons, should also be shown. If additional space is required, attach an additional sheet to this application.

Period of Service 1. Employer Reason(s) for leaving this From To 2. City, State Type of Work position (Mo., Yr.) (Mo., Yr.) 1. 2.

1. 2.

1. 2.

1. 2.

EXPERIENCES AND ABILITIES

Please indicate your number of years of experience moderating/coaching in blank (where applicable).

Academic Clubs and Extracurricular Activities Athletic Teams Special Skills

Band Newspaper Baseball Athletic Trainer Big Bro. / Little Bro. N.H.S./N.J.H.S. Basketball Commercial Driver’s License Campus Ministry Photography Bowling First Aid Cheerleaders Quiz Bowl Cross Country Other - List Below Chess Club Robotics eSports Chorus SCUBA Club Football Debate Service Programs Golf Drama Spanish Honor Society Lacrosse F.C.A. Student Council Sailing Fine Arts Guild Yearbook Soccer Intramurals Youth Legislature Swimming Key Club Other – List below Tennis Magic Club Track and Field Mathcounts Wrestling Mu Alpha Theta

What special gifts or talents do you possess?

List all honors you have earned.

REFERENCES

Full Name of Reference Address, City, State, Zip Phone Number Position Present Employer ( )

Previous Employer or College Advisor ( )

Other, Excluding Relative ( )

Answer the following questions in your own handwriting. If additional space is needed, use a separate sheet of paper and attach. Your application will not be processed without this information.

Why do you want to teach in a Catholic school?

What do you consider the mission of a Catholic school to be?

What do you feel would be your greatest contribution(s) to the mission of a Catholic school?

What three values are most important to you in the educational process?

Describe any aspect of your training or experience that would be an asset in the position(s) for which you are applying.

STATEMENT: Saint Stanislaus College does not discriminate against applicants or employees by reason of race, age, sex, handicap, or national origin. This non-discriminatory policy applies to hiring, training, salaries, promotions, and working conditions.

STATEMENT: I understand that any omission or misrepresentation of material fact provided on this application may result in refusal of or separation from employment. I hereby authorize Saint Stanislaus College to conduct investigations of my background deemed necessary, and to share all information contained herein with any principal in the Biloxi Diocese that might be interested in considering me for an educational position. I will sign any necessary release forms to assist in obtaining such information. I understand and agree that Saint Stanislaus College shall have the right at any time after my termination to furnish information to others regarding my employment, including the information contained on this application.

Signature of Applicant Date

PLEASE RETURN: FORWARD TO: 1. Application Principal 2. Small size photograph Saint Stanislaus College 3. Official copy of all college credits 304 South Beach Boulevard 4. Copy of teaching certificates Bay Saint Louis, MS 39520-4301 5. Resume

Note: Applications are maintained on file for two years. Documents submitted with this application become the property of Saint Stanislaus College and will not be returned.