Please enable JavaScript in your browser to complete this form.Your DetailsName *FirstMiddleLastAddress *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *EmailI will provide necessary documentation to validate that I am (Check a Box) *A citizen or national of the United States orAuthorized by the Immigration and Naturalization Service to work in the United StatesPosition DetailsApplying for *SubstituteFull-TimePart-TimeHave you ever worked for this school district?YesNoIf yes, when & where *Date available to Start *List any day or hours you are unable to work *List Any Friends or Relatives working here: List names and relationship of relatives working at this school districtPosition(s) Applying for *Administrative AssistantCookMaintenanceCustodianBookkeeperParaprofessional (Aide)Bus DriverBus MonitorTeacherOtherIf Other, please explain *Are you available to Work *Full-timePart-timeDaysNightsWeekendsPlease indicate your source of referralDistrict EmployeeNewspaperEmployment AgencyContacted On OwnOtherPlease choose your source for referral and enter the name belowReferral NameUnited States Military ServiceDo you have United States Military Experience? YesNoDate EnteredRank at Time of DischargePresent Military StatusBranchArmyMarine CorpsNavyAir ForceSpace ForceCoast GuardDate DischargedSpecial Skills or Training from ServiceEducation & TrainingPlease list educational institutions (high school, technical schools, college) attended beginning with the most recentName & Location of SchoolNumber of Years Completed1234Degree Earned/MajorName & Location of SchoolNumber of Years Completed1234Degree Earned/MajorName & Location of SchoolNumber of Years Completed1234Degree Earned/MajorWork ExperienceList below your previous employers, starting with the most current one.Employer NameDate HiredPhoneAddressDate LeftReason for LeavingPositionSupervisor -Name and TitleEmployer NameDate HiredPhoneAddressDate LeftReason for LeavingPositionSupervisor -Name and TitleEmployer NameDate HiredPhoneAddressDate LeftReason for LeavingPositionSupervisor -Name and TitleEmployer NameDate HiredPhoneAddressDate LeftReason for LeavingPositionSupervisor -Name and TitleAre there any other places you have worked in addition to those listed above?YesNoAdditional ExperiencePlease list any additional experience.Professional ReferencesInclude three professional references who supervised your previous work (principals, supervisors, superintendents).NameAddressInclude City, State & ZipPositionPhoneNameAddressInclude City, State & ZipPositionPhoneNameAddressInclude City, State & ZipPositionPhoneBackgroundTHIS SECTION MUST BE COMPLETED AS PART OF THE APPLICATION PROCESS. PLEASE MAKE CERTAIN THAT YOU ANSWER ALL OF THE QUESTIONS TRUTHFULLY. OMISSION OR FALSIFICATION OF ANY CRIMINAL INFORMATION WILL BE GROUNDS FOR IMMEDIATE DISMISSALHave you ever been convicted of an offense other than a minor traffic violation? *YesNoIf YES, when, where, and disposition of the convictionNote: An applicant for employment is not obligated to disclose sealed or expunged records of conviction or arrest. You are also not obligated to disclose expunged juvenile records of adjudication or arrest.Have you ever been convicted of, had adjudication withheld, pled no contest to, or entered a pretrial intervention program for a misdemeanor or felony criminal charge? YesNo(IF YES, EXPLAIN BELOW)If you answered "YES" to the question above, please explain in this field.Have you ever been the subject of an indicated report by DCFS or similar state agency?YesNoIf you answered "YES" to the question above, please explain in this field.Have you ever been suspended without pay, or dismissed from employment, or resigned while an investigation was in progress for possible disciplinary action?YesNoIf you answered "YES" to the question above, please explain in this field. *School Bus Driver Position Additional InformationThis section will only need ot be filled out if you are applying for a School Bus Driver Postion. All driver applicants who currently possess a Commercial Drivers License (CDL) or whose position for the school district would require a Commercial Drivers License (CDL) need to complete the section below. DOT requires that employment for at least 3 years and/or commercial driving experience for the past 10 years be shown.Employer Name *FirstLastContact Person *FirstLastPhoneDate LeftEmployer AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDate HiredReason for LeavingEmployer Name *FirstLastContact Person *FirstLastPhoneDate LeftEmployer AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDate HiredReason for LeavingEmployer Name *FirstLastContact Person *FirstLastPhoneDate LeftEmployer AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDate HiredReason for LeavingAccident RecordDate of AccidentAccident TypeHead-OnRear-EndOverturnFatalitiesYesNoInjuriesYesNoDate of AccidentAccident TypeHead-OnRear-EndOverturnFatalitiesYesNoInjuriesYesNoDate of AccidentAccident TypeHead-OnRear-EndOverturnFatalitiesYesNoInjuriesYesNoTraffic ConvictionTraffic Conviction’s and forfeitures for the past 3 years (other than parking violations) if none check no in the next question.Do you have any Traffic Conviction's and forfeitures for the past 3 years (other than parking violations)YesNoLocationLocationLocationDateDateDateChargeChargeChargePenaltyPenaltyPenalty1) Are you at least 21 years of age or older? YesNo2) Have you ever been denied a license, permit or privilege to operate a motor vehicle? YesNo3) Has any license, permit or privilege ever been suspended or revoked? YesNoIf you answered yes to question 2 oor 3 please provide any additional details here. License StateLicense NumberLicense TypeExpiration DateLicense StateLicense NumberLicense TypeExpiration DateLicense StateLicense NumberLicense TypeExpiration DateI understand that any offers of employment may be contingent upon my taking and successfully passing a drug and/or alcohol test in accordance with school district's policy. If I refuse to submit to testing, refuse to sign the school district consent form, or test positive, the school district will not employ me.I Understand and agree to the above paragraphCertificated Position & Substitute Teaching Position QuestionsPlease complete the following section if applying for a Certified Position or Substitute Teaching PositionMajorMinorAre you now under contract to teach?YesNoNumber of HoursNumber of HoursEndorsementsList any endorsements you hold:If applying for a high school or junior high position, what subjects are you licensed to teach in Illinois? At what grade level did you student teach?Please include the grade level and location/schoolWhich extra class activities (including intramurals or interscholastic athletics) are you willing to direct? Do you hold a valid Illinois License?YesNoIllinois Educator Identifying Number (IEIN)What is your preference for substituting?ElementaryJr. HighHigh SchoolSelect License Type(s)Professional Educator License (PEL)Educator License with Stipulations (ELS)Substitute LicensePlease list the ROE (s) that you are registered withSignatureBy signing below, I understand that the information provided is true and correct, and that any misstatements or omission of material facts in the application or the hiring process may result in discontinuing of the hiring process or termination of employment, no matter when discovered. I agree that the district shall not be held liable in any respect if my employment is terminated because of false statements, answers or omissions made by me in this application. I authorize the school district to analyze the truthfulness of all statements made on this application, complete reference checks from my current and former employers, and others that may provide information regarding my education and experiences. I also authorize a criminal background, sex offender, and other checks required by Federal and State government and the school code. I acknowledge that consideration for employment is contingent on the results of these background check(s). In addition, I give my consent for all contacted persons including current and former employers to provide information concerning this application, and I release each such person from liability for providing information to the school district. I hereby attest that all statements made by me above are true to the best of my knowledge, and I agree to the terms noted above. Signature * Clear Signature Date / Time *Submit