<p>Telluride School District R-1 Human Resources Department e-mail:[email protected] 725 W. Colorado Avenue Phone: 970-369-1231 Telluride, CO 81435 Fax: 970-369-1230</p><p>PARAPROFESSIONAL APPLICATION FOR EMPLOYMENT</p><p>Date : Social Security #: </p><p>Name: Last First Middle Mailing Address : P.O/Street City State Zip Telephone : e-mail: </p><p>Has this District previously employed you? Yes No </p><p>If so, dates and position(s): </p><p>Are you a certified teacher in Colorado or another state?: </p><p>Have you worked as a Paraprofessional before? : </p><p>Experience Pertinent to this Position: </p><p>Are you employed now? If so, may we inquire of your present employer? </p><p>Date Available for Employment: </p><p>Education Name and Location of School Years Date Subjects Studied Attended* Graduated* High School</p><p>College</p><p>Post Graduate</p><p>Trade, Business </p><p>Note: If including a resumé, if any of the above is duplicate information, please fill in “see resumé”. </p><p>Subjects of special study or research work: </p><p>What languages do you speak? Former Employers: Please list employment history beginning with the most recent. Attach a separate sheet if you need additional space:</p><p>Date Name, Address & Phone Number Position/ Reason for Salary Mo & Year of Employer Supervisor Leaving From Starting To Ending From Starting To Ending From Starting To Ending From Starting To Ending From Starting To Ending Note: If including a resumé, if any of the above is duplicate information, please fill in “see resumé”. </p><p>U.S. Military or Naval Service: Rank: Present member of National Guard or Reserves: </p><p>References: Give below the names of three persons not related to you, whom you have known at least one year.</p><p>Name Phone Number Business Yrs Acquainted 1. 2. 3. Note: If including a resumé, if any of the above is duplicate information, please fill in “see resumé”. </p><p>Do you have any physical defects that preclude you from performing any work for which you are being considered? Please explain: Are you able to lift up to 50 lbs? YES NO Have you ever been fired from a job? YES NO If so, what job & detail(s): </p><p>Have you ever been convicted of a crime? YES NO If so, dates & detail(s): </p><p>In case of Emergency, notify: </p><p>I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice.</p><p>Signature Date </p>