CERTIFIED TEACHER APPLICATION INSTRUCTIONS

School City of Whiting

1500 Center Street, Whiting, IN 46394

Phone: 219-659-0656 Fax: 219-473-4008

www.whiting.k12.in.us

CERTIFIED TEACHER APPLICATION

INSTRUCTIONS

The completed employment application can not be evaluated unless all of the following materials have

been provided:

1.

♦______ Application form fully completed and signed

2.

♦______ Current resume

3.

♦______ Copy of Indiana Teacher Certificate, Out-Of-State Teacher Certificate or a letter from

your college/university showing you have completed the requirements for a degree

4.

♦______ Copy of transcripts

5.

♦______ Skills Questionnaire fully completed

6.

♦______ If “yes” was answered to any of the questions in the background section, please attach

sheet explaining circumstances

7.

♦______ Expanded Criminal History Request form completed and signed.**

** NOTE: Only applicants recommended for employment with the School City of Whiting are required

to complete an expanded criminal background check. Once a candidate is selected, a $28.00 cashier’s

check or money order payable to the School City of Whiting will be required for an outside vendor to

conduct the applicant’s Expanded Criminal History Check.

The position is contingent upon the

completion of a satisfactory criminal background investigation. (see page 2 for district’s policy)

**NOTE: If you do not have a current IN Teacher License, you will need to apply for one online. The

link is https://license.doe.in.gov/login There is a fee for the license**

Please return the completed application packet to:

School City of Whiting

Human Resources Department

1500 Center Street

School City of Whiting

Expanded Criminal History Checks

Effective July 1, 2009, the State of Indiana requires all school corporations, to obtain an expanded

criminal history check on all new employees. The definition of “expanded criminal history check” is

found at IC 20-26-2-1.5, which is included below:

Sec. 1.5. "Expanded criminal history check" means a criminal history background check of an individual that

includes:

(1) a:

(A) search of the records maintained by all counties in Indiana in which the individual who is the subject of

the background check resided;

(B) search of the records maintained by all counties or similar governmental units in another state, if the

individual who is the subject of the background check resided in another state; and

(C) check of:

(i) sex offender registries in all fifty (50) states; or

(ii) the national sex offender registry maintained by the United States Department of Justice;

OR

(2) a:

(A) national criminal history background check (as defined in IC 10-13-3-12); and

(B) check of:

(i) sex offender registries in all fifty (50) states; or

(ii) the national sex offender registry maintained by the United States Department of Justice

.

To help ensure a safe environment and as required by state law, the School City of Whiting will obtain for

each individual hired for employment an expanded criminal history check.

The School City of Whiting has contracted with an outside vendor to conduct the expanded criminal

history checks. The cost of the expanded criminal history check will be the responsibility of the

applicant. The candidate will fill out the release and background information form and submit payment

to the district by cashier’s check or money order, payable to the School City of Whiting . This must

be done prior to the individual’s employment and no later than three (3) months after the individual’s

employment begins.

Failure to answer honestly any questions related to the expanded criminal history check may be cause for

immediate termination of the applicant’s employment.

**ALL employment with the School City of Whiting is contingent upon the

completion of a satisfactory criminal background investigation. Conviction or other

disposition of a crime is not necessarily an automatic bar to employment. The school

School City of Whiting

1500 Center Street, Whiting, IN 46394

Phone: 219-659-0656 Fax: 219-473-4008

www.whiting.k12.in.us

CERTIFIED STAFF

APPLICATION FOR EMPLOYMENT

School City of Whiting does not discriminate on the basis of race, color, sex, age, disability, religion or national origin.

This form must be filled out completely. All information will be treated in a confidential manner.

Your application will be kept on file for a period of one year from the date received.

BACKGROUND INFORMATION (Please print or type)

Date of Application: ____________________________

NAME: ________________________________ TELEPHONE: _________________

HOME ADDRESS: __________________________________________________________________________ CITY: ________________________________ STATE: _______________ ZIP: ____________________________ SOCIAL SECURITY NUMBER: ___________ -___________ -___________

MILITARY SERVICE:  YES  NO IF YES, DATE OF ENTRY: _________ DATE OF DISCHARGE:_________

POSITION DESIRED:

______ EARLY CHILDHOOD (PRE-K TO K) ______ JUNIOR HIGH (6-8) SPECIALIZATION: _______________ ______ ELEMENTARY (1-5) ______ HIGH SCHOOL (9-12) SPECIALIZATION: ______________ ______ OTHER (explain) _______________________________________________________________________________

CERTIFICATION:

Indiana State law requires all public school teaches to hold a valid teaching certificate or show proof of obtaining an Indiana license.

Do you have an Indiana teaching certificate? ______ YES ______ NO

If YES, certificate number: ______________________ Date of issue: ______________ Expiration date: _______________ Areas of specialization: _________________________________________________________________________________ If NO, and you are new to the profession or from out-of-state, have you started the process of applying for your Indiana certificate?

______ YES ______ NO Area of specialization: _______________________________________________

EDUCATION:

Diploma/Degree

STUDENT TEACHING EXPERIENCE: (For applicants with less than 3 years teaching experience)

School System Principal Supervising Teacher Grades/Subject Dates

PROFESSIONAL HONORS, DISTINCTIONS OR AWARDS:

EXTRA CURRICULAR ACTIVITIES:

Please list any activities that you can/would like to direct, supervise or coach:

TEACHING EXPERIENCE:

Do NOT list student teaching or substitute teaching experience. Show only creditable years for which service records are available up to and including teaching experience in the last 5 years, with the most recent first.

Please use additional sheets if needed.

Year Name of School and Address Position Grade/Subject Principal Reason for Leaving

REFERENCES:

Do not list relatives. List former employers, co-workers or others who can best describe your qualifications for this position. Give full name and address of each reference. In naming references, if you have had teaching experience, list supervisors, principals, and all superintendents who are familiar with your classroom work. If you have no teaching experience, give the names of the college instructors with whom you have your major subjects. You must include the name of the instructor who supervised your practice teaching course.

BACKGROUND QUESTIONS:

1.Have you ever been disciplined, discharged, refused employment or asked to resign

from a prior position? YES _______ NO _______ 2. Have you ever resigned from a position after being offered the opportunity to resign YES _______ NO _______ rather than be terminated?

4. Have you ever been charged, investigated for sexual abuse or harassment of another YES _______ NO _______ person or other offense relating to children?

5. Have you ever been arrested, convicted or received probation for a crime/offense in

the State of Indiana or any other state? YES _______ NO _______ 6. Have you ever entered a plea of guilty or “no contest” to any crime the State of Indiana

or any other state? (other than a minor traffic offense.) YES _______ NO _______ 7. Are you currently awaiting trial for a crime/offense you have been charged with? YES _______ NO _______ 8. Have you ever had a teaching certificate suspended or revoked in this state or any other state? YES ________ NO _______

NOTE:

** If you have answered YES to any of the previous questions, please provide full details on an additional sheet. Conviction or other disposition of a crime is not necessarily an automatic bar to employment. The school district will evaluate each case individually. **

APPLICANTS  CERTIFICATION  AND  AGREEMENT  

READ  THE  FOLLOWING  CAREFULLY  BEFORE  SIGNING  THIS  APPLICATION  FOR  EMPLOYMENT

Authorization and Release

I authorize the School City of Whiting to investigate and check my employment and criminal history, including without limitation, reference checks, and to seek the release of investigatory information, including my criminal history, possessed by any private or public employer or any local, state, or federal agency. I authorize these private or public employers or local, state, or federal agencies to release and to provide to the School City of Whiting any information they may possess concerning my employment or criminal history. This authorization for the release of information includes both records regardless of how stored or maintained and information by interview. I will cooperate to the extent necessary to obtain the release of this information.

I expressly waive and fully release the School City of Whiting, its agents, employees, attorneys, and/or board of school trustees from any and all claims or causes of action arising in connection with any request for or provision of such information, including without limitation, defamation, infliction of emotional distress, invasion of privacy or interference with contractual relations that I might otherwise have against the School City of Whiting, its agents, employees, attorneys, and/or board of school trustees, or against any individual, corporate, and/or agency provider of such information. I have read this Authorization and Release, and I expressly agree to the terms set out herein.

I also agree that a copy of this Authorization and Release, whether it be a photocopy, or otherwise, shall have equal standing and import as if it were an original.

Signature

Date

Signature

Date

______

School City of Whiting

1500 Center Street

Whiting, IN 46394

WRITTEN COMMUNICATIONS SKILLS QUESTIONNAIRE

for Certified Applicants

Name________________________________________ __ Date _______________________

DIRECTIONS: Please provide a handwritten response for each question below. If you have a disability which affects your ability to complete this questionnaire, let us know so that other arrangements can be made. If additional space is needed, please use additional sheets.

1. From your perspective, describe the characteristics of an effective classroom teacher.

2. What do you perceive to be your special skills and abilities as a classroom teacher?

4. What kind of things do you plan to do on a continuing basis to improve your skills, abilities and overall effectiveness as a classroom teacher?

NOTICE REGARDING BACKGROUND INVESTIGATION

A consumer report (background screening report) and/or an investigative consumer report which may include

information concerning your character, employment history, general reputation, personal characteristics, police

record, education, qualifications, motor vehicle record, mode of living, and/or credit and indebtedness may be

obtained in connection with your application for and/or continued employment with SCHOOL CITY OF

WHITING. A consumer report and/or an investigative consumer report may be obtained at any time during

the application process or during your employment with the SCHOOL CITY OF WHITING. You have the

right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the

nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most

common form of investigative consumer report obtained with regard to applicants for employment is an

investigation into your education and/or employment history conducted by Safe Hiring Solutions LLC, P.O. Box

295, Danville, IN 46122 888-215-8296.

AUTHORIZATION

By signing below, I,

, hereby voluntarily authorize SCHOOL CITY OF

WHITING to obtain either a consumer or an investigative consumer report about me from a consumer reporting

agency and to consider this information when making decisions regarding my employment and/or continued

employment at SCHOOL CITY OF WHITING. I understand that I have rights under the Fair Credit Reporting

Act, including rights discussed above. This report may be delivered in either written or electronic form.

Print Name (last, first, middle) Social Security Number

Date of Birth (MM/DD/YYYY) Drivers License Number Drivers License State

(For ID Purposes Only)

Any other names I have been known by: Current Address:

Previous Addresses (Last 7 Years)

Signature Date