<p> PULLMAN SCHOOL DISTRICT NO. 267 240 SE Dexter Street • Pullman, WA 99163 Personnel Office (509) 332-3584 • FAX (509) 334-0375 Website: www.psd267.wednet.edu</p><p>APPLICATION FOR CLASSIFIED PARAPROFESSIONAL EMPLOYMENT</p><p>Thank you for applying for a position in the Pullman School District. To be considered for an interview, please submit the following:</p><p> Pullman School District application form including the Applicant Disclosure Statement (completion of the Affirmative Action form is voluntary). PLEASE COMPLETE ALL SECTIONS ON THE APPLICATION FORM.  Formal typed letter of application addressing qualifications  Current resume  Copy of ALL college transcripts  Copy of applicable licenses or certificates  Two letters of recommendation (can be sent directly to the Pullman School District)</p><p>DATE:</p><p>DESIGNATE THE TYPE OF EMPLOYMENT FOR WHICH YOU ARE APPLYING:  Fulltime  Instructional Paraprofessional  Part-time  Title I  Substitute  Special Education  Learning Assistance Program (LAP)  Building  Playground Paraprofessional  Other: ______</p><p>BUILDING PREFERENCE:  Franklin Elementary  Jefferson Elementary  Sunnyside Elementary  Lincoln Middle School  Pullman High School  No Preference</p><p>PERSONNEL INFORMATION</p><p>Last Name First Name MI</p><p>Other Names Used Social Security No. </p><p>Temporary Address City State Zip</p><p>Permanent Address City State Zip</p><p>Telephone Message number Email CERTIFICATION</p><p>Type Number Date Issued Expiration Date</p><p>Driver’s License</p><p>Commercial License</p><p>Food Handler’s Permit </p><p>First Aid Certificate </p><p>CPR Certificate</p><p>Other</p><p>EDUCATION AND TRAINING (List most recent first)</p><p>Name of Institute Dates Degree Date of Major Minor GPA City, State Attended Degree Mo/Yr to Mo/Yr</p><p>MILITARY EXPERIENCE </p><p>Branch of Service Duties Dates Total Years Mo/Yr to Mo/Yr EMPLOYMENT EXPERIENCE (List most recent experience first)</p><p>Employer Name and Supervisor Dates: Mo/Yr to Mo/Yr Reason for Leaving From: </p><p>To: Address, City, State, Zip, Phone Number Position Title / Major Duties: </p><p>Employer Name and Supervisor Dates: Mo/Yr to Mo/Yr Reason for Leaving From: </p><p>To: Address, City, State, Zip, Phone Number Position Title / Major Duties: </p><p>Employer Name and Supervisor Dates: Mo/Yr to Mo/Yr Reason for Leaving From: </p><p>To: Address, City, State, Zip, Phone Number Position Title / Major Duties: </p><p>Employer Name and Supervisor Dates: Mo/Yr to Mo/Yr Reason for Leaving From: </p><p>To: Address, City, State, Zip, Phone Number Position Title / Major Duties: </p><p>Employer Name and Supervisor Dates: Mo/Yr to Mo/Yr Reason for Leaving From: </p><p>To: Address, City, State, Zip, Phone Number Position Title / Major Duties: </p><p>Employer Name and Supervisor Dates: Mo/Yr to Mo/Yr Reason for Leaving From: </p><p>To: Address, City, State, Zip, Phone Number Position Title / Major Duties: REFERENCES (Professional only – do not list friends or relatives)</p><p>Name Position / Relationship </p><p>Address , City, State Zip Telephone Home: Business: </p><p>Name Position / Relationship </p><p>Address , City, State Zip Telephone Home: Business: </p><p>Name Position / Relationship </p><p>Address , City, State Zip Telephone Home: Business: </p><p>Name Position / Relationship </p><p>Address , City, State Zip Telephone Home: Business: </p><p>• I hereby authorize the Pullman School District to make any investigation of my personal or employment history and authorize any former employer, person or organization to give Pullman School District any information regarding me. I release the Pullman School District, its employees and/or agents and all providers of information from any liability as a result of furnishing and receiving this information. </p><p>• I certify that the information presented in this application is true and complete to the best of my knowledge and I have read and understand that I have authorized the district to conduct reference checks. I understand if I am employed, false statements on this application may be cause for dismissal. </p><p>Signature Date </p><p>PULLMAN SCHOOL DISTRICT MAINTAINS A TOBACCO FREE AND DRUG FREE ENVIRONMENT</p><p>The Pullman School District does not discriminate in any programs or activities on the basis of sex, race, creed, religion, color, national origin, age, veteran or military status, sexual orientation, gender expression or identity, disability, or the use of a trained dog guide or service animal and provides equal access to the Boy Scouts and other designated youth groups. The following employee has been designated to handle questions and complaints of alleged discrimination: Assistant Superintendent, Pullman School District Administrative Offices, 240 SE Dexter Street, Pullman, WA 99163, (509) 332-3144, [email protected]. Applicants with disabilities may request reasonable accommodations in the application process by contacting the Human Resources Manager at (509) 332-3584.</p><p>PULLMAN SCHOOL DISTRICT IS AN EQUAL OPPORTUNITY EMPLOYER</p>