Employment

Name*

Phone Number (Best Contact)*

Email Address*

High School Name*

Year Graduated*

College Attended*

Major*

Degree*

Years Attended*

Additional education?

Additional education

Additional education detail*

Teaching Experience*

Please include dates employed, Employer name, address and phone number, Position, Salary, Wage, Supervisor's name and phone number, and your reason for leaving.

Dates employed	Employer name	Address	Phone Number	Salary	Wage	Supervisor's name	Supervisor's phone number	Reason for leaving

Most Recent Position*

Second Most Recent Position*

Third Most Recent Position*

Fourth Most Recent Position*

Please explain any gaps in employment*

Other Relevant Experience*

Please list any other experience you have, including dates, employer name address and phone number, position, salary, supervisor's name and phone number, and reason for leaving.

Dates	Employer name	Address	Phone number	Position	Salary	Supervisor's name	Supervisor's phone number	Reason for leaving

References*

Please list four individuals who are very familiar with your professional work and character who may be contacted. Please include their name, position, business phone, home or cell phone, email and address.

Name	Position	Business phone	Home or cell phone	Email	Address

Why do you want to become a teacher for the Shenandoah School of Hope?*

What experience do you have specific to the position you are applying for and how would you use that experience to be a success in the Shenandoah School of Hope?*

Describe your greatest accomplishment as an educator?*

List degrees, honors, commendations, elective or appointive offices held, or other distinctions received.*

Background Information

Are you, or have you ever been, listed on a sex offender registry?*

Yes
No

Have you ever been found guilty, accepted a guilty or Alford Plea, or entered a plea of no-contest for any criminal charge?*

Yes
No

Have you ever received a deferred judgment, or in some other way had a guilty plea or conviction removed from your record?*

Yes
No

Have you ever been asked to resign from a position, or been given the choice of resigning or being terminated from your position?*

Yes
No

If you answered “yes” to any of the above questions, provide date, incident, specific charge, city/state in which occurred:*

Yes
No

Have you ever been the subject of an investigation or other formal/informal proceeding that resulted in the termination of your employment or resignation?*

Yes
No

Have you ever been the subject of an investigation into wrongdoing or other formal/informal proceeding, resulting in disciplinary or criminal action?*

Yes
No

If yes, briefly explain.*

Responding "yes" to any of the previous questions is not an automatic bar to employment. The date of the offense and the relationship between the offense or infraction and the position for which you are applying will be considered.

Are you legally eligible to work in the United States?*

Yes
No

Do you wish to be considered for veteran’s preference?*

Yes
No

Veteran's Preference

Branch of Military*

Active Duty from (month/year)*

Active Duty to (month/year)*

Location of Duty*

Rank at Discharge*

Type of Discharge*

Reserve Duty From (month/year)*

Reserve Duty To (month/year)*

Obligation*

Times of Current Training Day*

Licenses

Do you hold a current Teacher’s License in Virginia or another state?*

Yes
No

Please list your endorsements*

Are you under contract with any current School District for next year*

Yes
No

Upload Resume*

Max. file size: 30 MB.

Provide LinkedIn url*

AGREEMENT (Read carefully before signing or submitting electronically)
By my signature:
• I acknowledge that individuals who provide false, inaccurate, or incomplete information in the application form, in an interview, or any other part of the hiring process or who fail to disclose information requested in the application form, in an interview, or any other part of the hiring process will not be eligible for employment, or, if they are hired, they will be subject to termination.
• I acknowledge that to the fullest extent permitted by state and federal law, the Shenandoah School of Hope, Inc. will consider all information concerning an applicant or an employee in making hiring, termination, and other employment-related decisions. The term "all information" includes information of any kind (verbal, written, photographic, videographic, etc.) that is accessible in any medium (print, electronic, etc.) from any source.
• I acknowledge that the Shenandoah School of Hope, Inc. will consider public information and other information to which it has lawful access. This may include information that is contained in social networking sites, blogs, and other electronic sites, such as YouTube. If there is information that pertains to me that I believe requires explanation, interpretation, or clarification when it is considered by the Shenandoah School of Hope, Inc., it is my obligation to communicate this information to the Shenandoah School of Hope, Inc.
• I authorize the Shenandoah School of Hope, Inc. to conduct a complete check regarding my background including, but not limited to, criminal record, child and dependent adult abuse registry screening, and sex offender registry. I agree to prepare and sign any other form necessary to complete a criminal background check. I further authorize all government agencies departments, bureaus, or related entities to release any and all information regarding my criminal history, if any. I agree to immediately notify the Shenandoah School of Hope, Inc. if I should be convicted of any crime while my application is pending, or during my period of employment, if hired.
• I authorize all current and former employers, teachers, and references to release all information regarding my professional competence, performance, character, and background. I waive any right I may have against any person contacted as a reference concerning this application.
• I acknowledge that information that is relevant to the Shenandoah School of Hope, Inc.’s decisions will be considered regardless of the date on which the Shenandoah School of Hope, Inc. obtains the information and regardless of the date on which the information was first published, created, or made accessible to the Shenandoah School of Hope, Inc.
• I understand that this application will be considered active for twelve (12) months from the date filed. I further understand that if I am employed by the Shenandoah School of Hope, Inc., this application and associated documents will become part of my permanent record.
• I understand that this application is not a contract of employment. In accepting the position, if hired, I understand that employment is at will, unless otherwise specified by the Code of Virginia. I acknowledge that the Shenandoah School of Hope, Inc. may discharge an at-will employee at any time for any legal reason or no reason at all.
• I agree to submit to both pre-employment and post-employment random drug and alcohol testing. By my electronic submission of this form:
• I attest that all the information contained in this application is accurate, complete, and true.
• I am bound by all elements of the agreement section of the application.
• I understand and accept that electronic submission will be considered equivalent to an original handwritten signature on a paper copy of the application.

Full Name*

Signature*

Date*

Shenandoah School of Hope, Inc.will select for employment qualified applicants for each position without improper discrimination on the basis of race, color, creed, religion, sex, sexual orientation, gender identity, national origin, ethnic background, age, or disability. Persons with disabilities who can perform the essential functions of an assignment with or without reasonable accommodation shall be considered qualified applicants. The Shenandoah School of Hope, Inc. shall take affirmative action in the recruitment, appointment, assignment and advancement of personnel to accomplish the goals of equal employment opportunity. In keeping with the law, the Shenandoah School of Hope, Inc. shall consider the veteran status of applicants.

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Background Information

Veteran's Preference

Licenses

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