аЯрЁБс>ўџ DFўџџџCџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅСY ПшbjbjѓWѓW ,T‘=‘=хџџџџџџ]~~~~ЮЮЮттттт юdтА ЖnnnnnMMMu w w w w w w $f єZ› ЮMIMMM› ~~nnлn   M~8nЮnu тт~~~~Mu l u ЖЮu nR +zзk‚Ътт]Ќu SYLVAN UNIFIED SCHOOLS DISTRICT 299 504 West 4th, Sylvan Grove, KS 67481 785-526-7175 APPLICATION FOR EMPLOYMENT Name _______________________________________________________ Address _____________________________________________________ City _____________________ State ____________ Zip __________ Phone _____________________ Permanent address (if different from above) ______________________ City _____________________ State ____________ Zip __________ Phone _____________________ FOR POSITION OF: ____Teacher ____Administrator Indicate grades, or secondary school subjects in order of preference: _____________________________________________________________ _____________________________________________________________ Applicants for admission and employment, students, parents, employees, sources of referral of applicants for admissions and employment, and all unions or professional organizations holding collective bargaining or professional agreements with the Sylvan Unified School District are hereby notified that this District does not discriminate on the basis of race, color, national origin, sex age, or handicap in admission or access to, or treatment or employment in its programs and activities. Any person having inquiries concerning the Sylvan Unified School District’s compliance with the regulations implementing Title VI, Title IX or Section 504 is directed to contact Judo Stecklein, Superintendent of Schools, Sylvan Grove, Ks. 785-526-7175, who has been designated by the Sylvan Unified School District to coordinate the District’s efforts to comply with the regulations implementing Title VI, Title IX, and Section 504. GENERAL INFORMATION Are there any positions for which you should not be considered, or job duties you cannot perform? _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Kind of certificate held ___________________________________________________ Date of expiration __________________________ Valid in Kansas ______________ When you could begin here ______________ Could you come for interview ______ Present salary ___________ Minimum salary you would expect ________ EXTRA CURRICULAR ACTIVITIES Please indicate which activities you could sponsor. Indicate training and previous experience. (debate, school plays, speech, band, vocal, cheerleading, football, basketball, baseball, track, etc.) _____________________________________________________________ _____________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ PERSONAL MESSAGE State briefly in your own handwriting why you desire this particular position. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ REFERENCES Give five references who have first-hand knowledge of your character, personality, scholarship, and teaching ability. Give references not used on college placement credentials. NameAddressPhone No.PositionTRANSCRIPT OF CREDITS High School: List school attended _____________________________________________________________ _____________________________________________________________ College: List schools attended, number of hours in various fields. Indicate major, minor and degrees. Send transcript of college work: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Graduate work- Institutes. List schools attended. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ TEACHER/ADMINISTRATOR EXPERIENCE Name & Location of Institution  # of TeachersGrades/Subject Taught --- Dates --- APPLICATION ACKNOWLEDGEMJ9NTS I certify that all the information provided by me in this application is true and complete. I understand that any misstatement, falsification, or omission of information is grounds for refusal to hire or, if 1 am hired and the same is discovered thereafter, termination. I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability for any damages that may result from furnishing this information to you. I authorize any background checks by any third party. I authorize you to request, receive and verify all information given on this application and release you from all damages that may result from your doing so. I authorize you to conduct a criminal background investigation using any and all methods necessary to succcssfully complete such investigation and I release you for all liability for any damages that may result from your doing so. I understand that if I am offered provisional employment in the school district that my fingerprints may be taken and a request made for a state and national criminal background check. I further understand that if the results of this criminal history check reveal that I have been convicted of any offense or any attempt to commit any offense specified in K.S.A. 1999, Supplement 72-1397 and amendments thereto that my employment may be terminated. If offered a position with USD 299, as a condition of employment I shall submit to a physical examination conducted by a physician of the board’s choosing, and costs therefore to be borne by the board. This examination may include a screening for illegal drugs (i.e. CDL holders). This application for employment shall be considered active for a period of time not to exceed 60 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. __________________________________ __________________ Signature of Applicant Date '(IWs2їјфш” • Љ Њ Щ   ƒyq0—аKдI{rtŠ•–w|УухчшћѕћѕёћэћъцъупмйэйъйэйэйЯйэйэйэйЫйЫЯэЫЫћћ5CJB*OJQJhnH CJCJ5CJ CJ 6CJCJ5CJ5CJ4 56CJ5CJ,$IVWrsАБя№12NO’“деёђњѕѕ№ющтдЮЩЩЩЩЩУЩЩЩЩЩУ ЦЬd№ ЦР „„єџd№ ЦР„Рd№d№d№d№d№$IVWrsАБя№12NO’“деёђ12yzИЙїј• Љ Њ Ћ  L M ‹ Œ Ъ Ы   j k Н О        ; < = CD‚ƒЫЬ)*yzИЙїј67uvДЕѓє23qr}~б"/05=ўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўdђ12yzИЙїј• Љ Њ Ћ  L M ‹ Œ Ъ Ы іяящуууууссмссеуууууЬЬdпў ЦЕ„Еdпўd№ ЦЬ Ц„pd№d№ ЦЬЫ   j k Н О        ; < = CD‚ƒѓэштшшшттттттйттвЫттттт„ѕ d№„d№ўd№ ЦЬ ЦЬd№ Ц| „d№ Ц|ƒЫЬ)*yzИЙїј67uvДЕѓє23qrњєєєэээчрєєєєєєєєєєєєєєєєє„d№ Цѕ „ѕ d№ ЦЬd№r}~б"/05=GPQRSTUVWXYјђыыыышшшшЪХХХХЇХХХ$$–”жж тџЪАм#$$$$–”Ÿжж тџЪАм#$„d№ Ц“ „“ d№=GPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~€‚ƒ„…†‡ˆ‰Š‹ŒŽ‘’“”•–—­ЎаLMдPŽЬ HI{Йї5st•–ЖХлыьўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўdYZ[\]^_`abcdefghijklmnopqrњмњњњњмњњњњмњњњњмњњњњмњњњ$$–”жж тџЪАм#$$rstuvwxyz{|}~€‚ƒ„…†‡ˆ‰Š‹њмњњњњмњњњњмњњњњмњњњњмњњњ$$–”жж тџЪАм#$$‹ŒŽ‘’“”•–—­ЎаLMдPŽњмњњњњмњњњњмзеЮХЮХОХХХ„d№ўdh ЦЬ„dhd№$$–”жж тџЪАм#$$ŽЬ HI{Йї5st•–ЖХлыьэюяііі№чірір№ййжжжбГЎЎЎ$$$$–”Ÿжж тџ АЎu%$$$„Ud№„dhd№ў Ц/ ЦЬdh ЦЬьэюя№ёђѓєѕіїјљњћќ§ўџ     89HI  ЋЌ“”UVopwxyz{|УухцчшўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўќњјњњњіііііііієўўєHя№ёђѓєѕіїјљњћќ§ўџњмњњњњмњњњњмњњњњмњњњњмњњњ$$–”жж тџ АЎu%$$     89HIњмњњњњмњњњњмњњњњмггЭЦНdыў ЦЬ„dыў ЦСd№ ЦС$$–”жж тџ АЎu%$$I  ЋЌ“”UVopwxyz{|УухцчшѓъукукукгкггггггбгЬббЬd№„dыўdыў ЦЬ„dыўdыў ЦЏ „dыў Ц|* 00PАа/ Ар=!А"А№#F$ %АА  [D@ёџD Normal1$7$8$H$CJ_HaJmH sH tH <A@ђџЁ< Default Paragraph Font$ўOђ$ c1$d№a$$ўO$ c2$d№a$$ўO$ c3$d№a$$ўO"$ c4$d№a$.ўO2. p5 ЦР„рd№^„р&ўOB& p6 ЦЬd№.ўOR. p7 ЦН„ d№^„ .ўOb. p8 Цp„аd№^„а.ўOr. p9 Ц„| d№^„| (ўO‚( p10 ЦЬd№(ўO’( p11 ЦЬdЛ.ўOЂ. p2 ЦЕ„ыd!^„ы.ўOВ. p3 Ц|„$d№^„$&ўOТ& p4 ЦЬd.ўOв. p1 Цѕ „Ud№^„UўOт t3d№ўOђ t6d№шџџџџџџџџџџшTџџџџшђЫ ƒrYr‹ŽяIш "#$%'()=ьш!&№8№@ёџџџ€€€ї№’№№0№( № №№B №S №ПЫџ ?№шхщ ЌЖјуф”FO’žиѕ Ѓ “ – б м "-ЂЄIехщџџSylvan Unified SchoolsDC:\WINDOWS\TEMP\AutoRecovery save of application-certifiedemploy.asdSylvan Unified SchoolsE\\SAMBA\AR\Transfer\Scanned Documents\application-certifiedemploy.docSylvan Unified SchoolsE\\SAMBA\AR\Transfer\Scanned Documents\application-certifiedemploy.docSylvan Unified SchoolsE\\SAMBA\AR\Transfer\Scanned Documents\application-certifiedemploy.docSylvan Unified Schools/C:\My Documents\application-certifiedemploy.docSylvan Unified Schools/C:\My Documents\application-certifiedemploy.docSylvan Unified Schools/C:\My Documents\application-certifiedemploy.docSylvan Unified Schools/C:\My Documents\application-certifiedemploy.docSylvan Unified Schools/C:\My Documents\application-certifiedemploy.docSylvan Unified SchoolsE\\SAMBA\AR\Transfer\Scanned Documents\application-certifiedemploy.docџ@€{{(ЕФ{xтџР{шр@G‡:џTimes New Roman5€Symbol3& ‡:џArial"Сˆ№аhЋм&Ћм&ЪЊм& 1ПЈ!!№ЅРxxƒ2>gџџSYLVAN UNIFIED SCHOOLSStudentSylvan Unified Schoolsўџ р…ŸђљOhЋ‘+'Гй0 ˜ РЬмшє (4 P \ h t€ˆ˜фSYLVAN UNIFIED SCHOOLSYLVStudenttudtud Normal.dotISylvan Unified Schools2lvMicrosoft Word 8.0o@@dŽm`‚Ъ@ŠWОk‚Ъ@ŠWОk‚Ъўџ еЭеœ.“—+,љЎDеЭеœ.“—+,љЎD hp|„Œ” œЄЌД М пфN1 >j SYLVAN UNIFIED SCHOOLS Title˜ 6> _PID_GUIDфAN{012938F4-EE1B-11DE-8E70-000EA603DE41}  !"#$%&'()*ўџџџ,-./012ўџџџ456789:ўџџџ<=>?@ABўџџџ§џџџEўџџџўџџџўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџRoot Entryџџџџџџџџ РFћћјH‚Ъ`Sƒзk‚ЪG€1Tableџџџџџџџџџџџџ+WordDocumentџџџџџџџџ,TSummaryInformation(џџџџ3DocumentSummaryInformation8џџџџџџџџџџџџ;CompObjџџџџjObjectPoolџџџџџџџџџџџџ`Sƒзk‚Ъ`Sƒзk‚Ъџџџџџџџџџџџџўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџўџ џџџџ РFMicrosoft Word Document MSWordDocWord.Document.8є9Вq