Support Staff Application

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Support Staff Application

BEFORE YOU START

The job openings are posted in the District Office, district schools, and on our website: www.newberg.k12.or.us. If a position interests you, ask yourself these questions: Do I understand what the job is? Can I do the work being advertised? Do I meet the

qualifications for the work with enough of the right kinds of training, experience, skills,

knowledge, and abilities? If the answers are yes and you wish to apply for one of our current job openings, please complete a job application provided by Newberg School District and return it to Human Resources by the closing date on the job posting. The employment process may proceed only after the closing date for any posting. If a posting states “Open Until Filled,” a position may be filled at any time.

WHEN COMPLETING THE APPLICATION FORM

Complete every question. Type or use black or blue ink and print neatly. We must be able to read the information on your application. Remember, if there is a closing date stated on the job posting, the completed application must be returned by the stated deadline. Do not contact the site where the position is located (i.e., School Principal or Supervisor).

We suggest that you keep a copy of a completed application in your records to facilitate the completion of an application for any openings in other areas around the same time period for which you may wish to apply. For instance, if you apply for an educational assistant opening but a clerical position opens before the educational assistant position is filled and you wish to apply for the clerical opening, you will need to submit another complete application for

consideration. You may submit a copy of the application with an original signature and date. For openings in subsequent years, you may call to reactivate your application up to three years from the date received.

Do not substitute a résumé for any part of the application form. Copies of résumés, letters of recommendation, awards, certificates or similar documents may be submitted if they are related to the job for which you are applying. However, they may not be submitted in lieu of a completed job application. All materials submitted with your application become the property of Newberg School District and cannot be returned or copied from our records. Therefore, do NOT submit original documents with your application. If you choose to submit original documents with your application, please make copies of the originals for yourself for future use.

Before submitting your application, check to be sure you have answered all the questions. Also check that your application is neat and legible. Remember, if we cannot read it, we will not know all your qualifications. If you need more space to explain your qualifications, insert additional pages that have your name and the name of the position for which you are

applying at the top. Please make sure that you have signed and dated your application.

AND FINALLY

Your application and qualifications for the position will determine if you are selected for an interview. Following these suggestions does not guarantee that you will be recommended for

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the position for which you are applying, but we hope this information will help you prepare the best application possible. Thank you for your interest in working for Newberg School District.

We are an equal opportunity and nondiscriminatory employer as mandated by Section 504 of the Office of Civil Rights. State and federal governments require employers to collect

race/ethnic, sex, age, and handicap information from applicants. This information will be kept separate and confidential and will be used for recordkeeping purposes only. You are helping us meet legal requirements when you give us this information.

Application Procedures:

1. Applicants are considered only when applications and other materials are submitted or reactivated by the posted deadline for an open position.

2. Supervisors of open positions will screen applications and contact applicants for interviews.

3. Reference checking will occur before a finalist is offered the position. 4. The finalist must be fingerprinted prior to starting the position.

5. Assignment to positions within the district is made by the Superintendent or designee and may be subject to change.

6. Applications are left on file for a period of three years from the date of receipt during which time they may be reactivated by calling Human Resources prior to the closing date of an open position.

7. Please be patient; do not call to request the status of the opening. If you are to be interviewed, you will be called; if not, you will eventually receive a letter.

It is the policy of Newberg School District 29J to comply with the provisions of the Fair Employment Practices Act and Title IX Regulations related to employment practices,

educational programs, and activities. Qualified individuals with disabilities may be entitled to reasonable accommodation to perform the essential job functions as specified by the

Americans with Disabilities Act of 1990.

Newberg School District 29J 714 East Sixth Street Newberg, Oregon 97132

Phone: 503-554-5000 Fax: 503-538-4374

An Equal Opportunity Employer A Fair Share School District

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Employment History (continued)

Do not state “See Résumé.” Please fill out completely, including supervisor’s name and phone number.

Employer _______________________________ Immediate supervisor and title ________________________ Address____________________________________________ Phone _______________________________ Job title ____________________________________________ Ending salary/hourly rate _________________ From Mo.______ Yr. ______ to Mo.______ Yr. ______ May we contact for references?  Yes  No

Description of job duties

____________________________________________________________________________________ ____________________________________________________________________________________ Reason for Leaving

____________________________________________________________________________________

Employer _______________________________ Immediate supervisor and title ________________________ Address____________________________________________ Phone _______________________________ Job title ____________________________________________ Ending salary/hourly rate _________________

From Mo.______ Yr. ______ to Mo.______ Yr. ______ May we contact for reference?  Yes  No

________________________________________________________________________________________ _________________________________________________________________________________________ Reason for Leaving

_________________________________________________________________________________________

Employer _______________________________ Immediate supervisor and title ________________________ Address____________________________________________ Phone _______________________________ Job title ____________________________________________ Ending salary/hourly rate _________________

_________________________________________________________________________________________ _________________________________________________________________________________________ Reason for Leaving

_________________________________________________________________________________________

 Please explain any gaps in employment.

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NEWBERG SCHOOL DISTRICT 29J SUPPORT STAFF APPLICATION EXPERIENCE AND TRAINING ADDENDUM

Please use key to indicate experience or training in any of the following specific areas: Key: E = Experience T = Training T/E = Both

Secretarial/Receptionist/Clerical Applicants: Must submit cover letter and résumé also.

___ Accounting ___ Receptionist

___ Accounts Payable ___ Secretary

___ Accounts Receivable ___ Supervising Employees

___ Bookkeeping ___ Supervising Student Workers

___ Briefhand/Shorthand: ____wpm ___ Switchboard

___ Filing ___ Ten-Key By Touch

___ Mailing Machine ___ Machine Transcription

___ Payroll ___ Typing: ____wpm

___ Purchasing ___ Word Processing: ____wpm

___ Computers: __ PC __ Macintosh ___ Software Used: ____________________ ___ Spreadsheets/Database ____________________________________

Please provide any additional comments you wish to make concerning your qualifications:

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Custodial/Maintenance/Grounds/Courier/Warehouse Applicants: ___ Bloodborne Pathogen Training ___ HVAC/Boiler

___ Carpentry ___ Industrial Cleaning

___ Carpet Cleaning/Repair ___ Inventory Control ___ Computer Skills ___ Landscaping/Irrigation

___ Concrete Flatwork ___ Mechanical

___ Custodial/Housekeeping ___ Painting

___ Drywall ___ Plumbing: License #_______________

___ Electrical: License #_______________ ___ Roofing

___ Energy Management ___ Sheet Metal

___ Fiber Optics ___ Warehouse

___ Forklift ___ Welding

___ Groundskeeping ___ Wood Floor Refinishing

___ Hazardous Materials Training/MSDS

Have you supervised other workers?  Yes  No If yes, please describe: _______________ ______________________________________________________________________________ ______________________________________________________________________________ Please provide any additional comments you wish to make concerning your qualifications:

______________________________________________________________________________ ______________________________________________________________________________

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Educational/Instructional Assistant Applicants:

___ Audiovisual Equipment ___ Library/Media Centers

___ Campus Security ___ Bookmending

___ Computers: __ PC __ Macintosh ___ Playground Supervision ___ Software Used: ___________________ ___ Typing: ____wpm

____________________________________ ___ Word Processing: ____wpm

With what grade level of students have you worked? ___________________________________ Describe training or experience you have had working with school-age children: _____________ ______________________________________________________________________________ ______________________________________________________________________________ What training or coursework have you had in child development or early childhood development? ______________________________________________________________________________ ______________________________________________________________________________ What abilities and experiences have you had working with individual students and groups of students in reading and math? _____________________________________________________________ ______________________________________________________________________________ Describe your experience with alternative ed students: __________________________________ ______________________________________________________________________________ What experience have you had working with children with disabilities? ____________________ ______________________________________________________________________________ ______________________________________________________________________________ Describe the disabling conditions involved: __________________________________________ ______________________________________________________________________________ Are you capable of lifting a child with disabilities weighing 50 to 100 pounds?  Yes  No Are you willing to feed and toilet students with disabilities?  Yes  No

Have you worked with behaviorally aggressive students?  Yes  No

Describe talents you have that would be helpful in working with students with disabilities: _____ ______________________________________________________________________________ Why do you wish to work with students with disabilities? _______________________________ ______________________________________________________________________________ ______________________________________________________________________________ Describe training and/or experience you have had with hearing impaired, visually impaired, or autistic children: ______________________________________________________________________ ______________________________________________________________________________ Describe your experience with ESL, migrant or bilingual students: ________________________ ______________________________________________________________________________ Describe your knowledge of community agencies and/or resources that are related to youth/human services: _______________________________________________________________________ ______________________________________________________________________________ Please provide any additional comments you wish to make concerning your qualifications: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

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Food Service Applicants:

___ Baking ___ Menu Planning

___ Cashier ___ Ordering Food/Supplies

___ Computer Skills ___ Pulper

___ Dishwashing ___ Quantity Food Preparation (50 or more) ___ Industrial Kitchen Equipment ___ Supervising

Do you have a current food handler’s card for Oregon?  Yes  No

Have you been employed in food service areas?  Yes  No If yes, describe the work and responsibilities: ________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Describe training or experience you have had working with school-age children: _____________ ______________________________________________________________________________

Technology Applicants: Must submit cover letter and résumé also. ___ Certified Novell Administrator ___ Programming

___ Certified Novell Engineer ___ Experience with GroupWise ___ Install and format new computer hardware ___ Experience with LAN Networks ___ Repair and maintenance of PC computers ___ Experience with WAN Networks ___ Repair and maintenance of Macintosh computers

___ Install and format software on all platforms (Windows and Macintosh) ___ Troubleshoot and diagnose hardware/software problems on PC machines ___ Troubleshoot and diagnose hardware/software problems on Macintosh machine ___ Troubleshoot and diagnose network problems

Supervisor/Coordinator Applicants: Must submit cover letter and résumé also. ___ Bid Specifications & Procedures ___ Evaluating Product/Equipment Purchases ___ Budget Preparation ___ Knowledge of Appropriate State Law ___ Collective Bargaining ___ Management of Department

___ Computer Skills ___ Negotiations

___ Contract Management ___ Staff Performance Evaluations ___ Coordinating Work Schedules ___ Staff Supervision

Have you conducted employee training/inservices?  Yes  No Describe: _____________ ______________________________________________________________________________ ______________________________________________________________________________

For all of above: Please provide any additional comments you wish to make concerning your qualifications: __________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

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Coach and Advisor Applicants:

Check those you are capable of and willing to supervise. V=Varsity, JV=Junior Varsity, F=Freshman

Positions Qualified to Conduct Coaching/Advising Exp Level

Head Asst V JV F Elem MS HS College

Accompanist (Choir/Musical)          Activities Coordinator          Athletic Coordinator (MS)          Athletic Director          Band/Jazz Band          Baseball          Basketball          Club Advisor (FFA/DECA/FBLA)          Cross Country          Dance          Drama          Football          Golf          Instructional Leader/Dept. Head          Intramurals          Junior Class/Prom Advisory          May Day          Music – Elementary          Musical          Newspaper          Orchestra          Rally          Soccer          Softball          Sophomore Class Advisor          Speech Team          Student Council          Student Store          Swimming          Technology Support (Bldg Level)          Tennis          Track          Translator          Vocal Music          Volleyball          Water Polo          Wrestling          Yearbook/Annual         

Please state your philosophy of coaching (attach additional sheet if necessary): ______________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

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Education

Circle last grade completed: 6 7 8 9 10 11 12 Business/Technical/College: 1 2 3 4 5 6 Starting with high school, list schools attended and their location:

List any school course, training, licenses, certification, or other qualifications which relate to your suitability for this position:

__________________________________________________________________________________ Other Information

a. Do you possess a Current Oregon Teaching License?  Yes  No

If yes, type ______________________________________ expiration date ______________________________ b. Do you possess a Medic First Aid Card?  Yes  No If yes, expiration date & attach copy ______________ c. Do you possess a valid driver’s license?  Yes  No If yes, what state ___________________________ d. Do you know sign language (for the hearing impaired?)  Yes  No

e. Are you fluent in speaking, writing, and reading English?  Yes  No

f. Second language(s) spoken _____________________________________________________________________ g. Please list any relatives (and relationship) presently employed by the Newberg School District: _________________________

h. Would you be willing to attend training sessions on job-related topics when such training is offered by the Newberg School District?  Yes  No

Additional References (Work-related references other than supervisors listed under the Employment history section.

Please do not list relatives.)

Federal Regulation

The Federal Immigration Reform and Control Act requires individuals to provide to an employer documented proof that they are authorized to work in the United States. This proof must be provided to, and verified by, employers at the time of hire.

Are you authorized to work in the United States? Yes No

Name Address/ Zip Code Telephone Relationship Position/Title School Dates Attended

From To

Degree Course of Study/ Number of College Credits

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Personal Information

 Required

The following questions are to assist in determining a prospective employee’s fitness as an applicant. The answers to these questions are subject to verification by a police agency. A “yes” answer does not automatically disqualify an applicant. Each case will be judged individually.

Have you ever been convicted of:

a. A sex-related crime which involved force or minors?  Yes  No b. A crime involving violence or the threat of violence?  Yes  No c. A crime involving criminal activity in drugs or alcohol?  Yes  No d. Any other conviction other than a minor traffic violation?  Yes  No

Have you even been arrested for a sex offense, crimes involving minors, sale and distribution of a controlled substance or alcoholic beverage, possession and/or use?  Yes  No

If yes, please indicate on the line below the charge and/or disposition:

Are you currently charged with or under indictment for any of the above?  Yes  No Have you ever been terminated or resigned in lieu of termination for any incident regarding inappropriate behavior involving children?  Yes  No

Have you ever been terminated or resigned in lieu of termination for any reason?  Yes  No

If yes, please explain on the line below :

Are you able to perform the essential functions of the position for which you are applying, with or without reasonable accommodations?  Yes  No

Applicant’s Statement

I hereby certify that this application contains no misrepresentation or falsifications and that the information given is true and complete to the best of my knowledge and belief. I understand that if employed, false statements on this application shall be considered sufficient cause for immediate dismissal. I authorize the district to check criminal records by my signature on the appropriate forms. I further agree to hold the district and any persons or corporations responding to my employment history investigation harmless from any legal action based on such investigation.

Applicant signature _________________________________________ Date _____________________ Note: Final employment is subject to criminal record clearance through fingerprinting or criminal background check.

Drug-Free Workplace

The district is committed to maintaining a drug-free workplace and strictly complies with the Drug-Free Workplace Act of 1988 and the Drug-Free Schools and Communities Act amendments of 1989.

Equal Opportunity

The Newberg School District, an equal opportunity employer, complies with all applicable state and federal statutes in employment and school district programs.

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This information is collected in accordance with the Newberg School District equal employment opportunity plan and will not be used for purposes of discrimination.

1. Are you a “Veteran” as defined under Oregon law (ORS 408.225(e))?  Yes  No

(e) “Veteran” means a person who:

(A) Served on active duty with the Armed Forces of the United States:

(i) For a period of more than 90 consecutive days beginning on or before January 31, 1955, and was discharged or released under honorable conditions;

(ii) For a period of more than 178 consecutive days beginning after January 31, 1955, and was discharged or released from active duty under honorable conditions;

(iii) For 178 days or less and was discharged or released from active duty under honorable conditions because of a service-connected disability;

(iv) For 178 days or less and was discharged or released from active duty under honorable conditions and has a disability rating from the United States Department of Veterans Affairs; or

(v) For at least one day in a combat zone and was discharged or released from active duty under honorable conditions;

2. Are you a “Disabled Veteran” as defined under Oregon law (ORS 408.225(c))?  Yes  No

(c) “Disabled veteran” means a person who has a disability rating from the United States Department of Veterans Affairs, a person whose discharge or release from active duty was for a disability incurred or aggravated in the line of duty or a person who was awarded the Purple Heart for wounds received in combat.

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DATE ____________________

This information is collected in accordance with the Newberg School District equal employment opportunity plan and will not be used for purposes of discrimination.

Print Name: ______________________________________________________________________ LAST FIRST M.I.

Date of Birth: _________________________ Gender: ____Female ____Male

Disability: ____No ____Yes (Please Specify:) ________________________________________

POSITION FOR WHICH YOU ARE APPLYING: (Circle appropriate number(s)) 1. Secretary/Clerical/Receptionist 5. Technology Support Specialist 2. Custodian/Maintenance/Grounds 6. Supervisor/Coordinator 3. Educational/Instructional Assistant 7. Coach/Advisor

4. Food Service/Cook/Kitchen Manager 8. Other ___________________________

1. Are you of Hispanic, Latino, or Spanish ethnicity: __ Yes __ No

Includes persons of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin.

If you answered “Yes” to question #1, you must also check one or more of the racial categories in question #2. If you answered “No”, please check one or more of the following racial categories.

2. Racial Categories:

American Indian or Alaska Native

Origins in any of the original peoples of North, Central, and South America who maintain a tribal affiliation or community attachment.

Asian

Origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent for example Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, Philippine Islands, Thailand, and Vietnam.

Black or African American

Origins in any of the black racial groups of Africa Native Hawaiian or Other Pacific Islander

Origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. White

Origins in any of the original peoples of Europe, the Middle East, or North Africa.

It is the policy of the Newberg School District Board of Education and School District that there will be no discrimination or harassment on the grounds of race, color, sex, sexual orientation, gender identity, marital status, religion, national origin, age or disability in any educational programs, activities or employment. Persons having questions about equal opportunity and nondiscrimination should contact the Superintendent/ Title IX Coordinator. Persons having questions about special needs should contact the Director of Special

Programs/Section 504 Coordinator at the Newberg School District Office, 714 E. Sixth Street, Newberg, Oregon 97132, Phone 503.554.5000.

AFFIRMATIVE ACTION INFORMATION