<p> South Harrison Elementary School District</p><p>Substitute Application Procedures:</p><p>Thank you for your interest in the Kingsway Regional School District. Prior to board approval as a district substitute teacher, the following information must be completed and returned to the district office:</p><p>Applicants WITH a NJ State teaching or county substitute certificate must complete A-I:</p><p>A. ___ Completed substitute teaching employment application (http://www.kingsway.k12.nj.us/DistrictOffice/SubstituteTeachers.html)</p><p>B. ___ Criminal history verification (fingerprinting) * (MorphoTrack/$70.25 fee – visit www.bioapplicant.com/nj or call 1-877-503-5981 to schedule an appointment online or via phone.)</p><p>C. ___ Applicant Authorization & Certification Form (Criminal History Review) Completed online at: http://www.nj.gov./education/educators/crimhist/. (An $11.00 processing fee applies – credit card payments accepted online)</p><p>D. ___ Complete I-9</p><p>E. ___ Complete W-4 </p><p>F. ___ Employee Health History Form</p><p>G. ___ Proof of negative TB test (Mantoux)</p><p>H. ___ Employee Emergency Form</p><p>I. ___ Direct Deposit Form</p><p>K. ___ Two forms of identification: driver’s license and social security card</p><p>L. ___ Contact Principal’s Office to arrange interview</p><p>Applicants WITHOUT a NJ State teaching or county substitute certificate must complete step J:</p><p>J. ___ County Substitute Application with the following attachments:  Official college transcript (at least 60 credits)  $125.00 personal check or money order payable to: The Commissioner of Education  Copy of Criminal History Approval Letter (fingerprinting)  Oath of Allegiance (must be notarized)</p><p>APPLICATION FOR SUBSTITUTE TEACHING/NURSING EMPLOYMENT</p><p>Page 1 SOUTH HARRISON ELEMENTARY SCHOOL DISTRICT Substitute</p><p>DATE: S.S. No. </p><p>NAME: Last First M</p><p>ADDRESS: Street City State Zip Code</p><p>PHONE: H ( ) EMAIL: C ( ) </p><p>Position(s) Applying For: </p><p>Present Position/Status: </p><p>Date of Availability </p><p>Certification(s) Held: </p><p>Highly Qualified Status (List Areas): </p><p>Present Salary </p><p>Expected Salary </p><p>List College Activities, Honors, et. </p><p>Ever Been Convicted of A Crime? Yes No </p><p>If Yes, Please Explain: </p><p>The South Harrison Elementary School District has a strict Nepotism Policy. Therefore, are you related to any member of the Board of Education and/or administrators employed by the District? Yes No </p><p>EDUCATION Name of School & Dates Duration Semester, Degree or Major/Minor </p><p>Equal Opportunity Employer Page 2 SOUTH HARRISON ELEMENTARY SCHOOL DISTRICT Substitute</p><p>Location (including High School, College, Graduate, Other) Credits Diploma Credits From: </p><p>To: </p><p>From: </p><p>To: </p><p>From: </p><p>To: </p><p>EMPLOYMENT HISTORY Position/Nature of Name of School and/or Work (Grades/ Company & Location Dates Number of Years Subjects) From: To: From: To: From: To: </p><p>OTHER SCHOOL RELATED EXPERIENCE Employer Dates Number of Years Nature of Work From: To: From: To: From: To: </p><p>Equal Opportunity Employer Page 3 SOUTH HARRISON ELEMENTARY SCHOOL DISTRICT Substitute</p><p>REFERENCES List at least three (3) names and contact information of persons qualified to give any information to show your fitness for the position you are seeking. Please include Superintendents and Principals under who you have taught/worked.</p><p>Name Address Telephone</p><p>Credentials are on File At: </p><p>Please add any additional information you believe will assist in arriving at a true estimate of your qualifications:</p><p>Please submit this application to: Dr. James J. Lavender Superintendent of Schools South Harrison Elementary School District 904 Mullica Hill Road Harrisonville, New Jersey 08039</p><p>Falsification of the Employment Application, Resume or Interview Documents will Result in Forfeiture of the Position.</p><p>I certify that all the information provided in this application and attached resume is true to the best of my knowledge and belief.</p><p>Applicant’s Signature (Date)</p><p>Equal Opportunity Employer Page 4</p>