Employment Application form to apply for a position with Hoosick Falls CSD Job Applying for:*substitute teachersubstitute aidesubstitute bus driversubstitute food helperName* First Middle Last Present Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Permanent Address* Same as present address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Enter Email Confirm Email Phone*Other PhoneAre you legally eligible for employment in this country?* YES NO In accordance with the Immigration Reform and Control Act of 1985, upon employment you will be asked by your supervisor to produce two original forms of identification.Date available:* MM slash DD slash YYYY Building/Location desired:* Elementary School Jr. / Sr. High School No preference Have you previously applied to this School District?* YES NO If yes, when?* Educational BackgroundEducational Background* High School College / University Other (military/vocational) check all that apply to your backgroundName/location of school* Number of years completed* Degree or diploma?* YES NO Name/location of school* Number of years completed* Degree or diploma?* YES NO Degree awarded:* Name / location of school (or branch of military)* Number of years completed* Any certificates / awards?Employment HistoryHave you ever been employed?* YES NO Job Experience #1Company Name* Company address*Dates employed* From mm/dd/yyyy to mm/dd/yyyyJob title & duties*reason for leaving* Supervisor’s Name and Number*May we contact?* YES NO Salary* 1 - Add additional job experience?* YES NO HiddenJob Experience #2Company Name* Company address*Dates employed* From mm/dd/yyyy to mm/dd/yyyyJob title & duties*Dates employed* From mm/dd/yyyy to mm/dd/yyyyreason for leaving* Supervisor’s Name and Number*May we contact?* YES NO Salary* 2. Add additional job experience?* YES NO HiddenJob Experience #3Company Name* Company address*Dates employed* From mm/dd/yyyy to mm/dd/yyyyreason for leaving* Supervisor’s Name and Number*May we contact?* YES NO Salary* ReferencesPlease provide contact information for at least three (3) individuals who have closely observed your work. Former supervisors are preferred. Please note that some or all of your references will be contacted unless you direct otherwise.Reference #1*Please write the name of a reference, their contact info (name & phone number), what their job title is, how you know them, and how long you've known them. Reference #2*Please write the name of a reference, their contact info (name & phone number), what their job title is, how you know them, and how long you've known them. Reference #3*Please write the name of a reference, their contact info (name & phone number), what their job title is, how you know them, and how long you've known them. Additional SkillsSummarize special skills, qualifications, awards and honors achieved from employment, education or other professional experience:Summarize special skills, qualifications, awards and honors achieved from employment, education or other professional experience:PLEASE ANSWER THE FOLLOWING QUESTIONS:Have you ever resigned from a position rather than face disciplinary action?* YES NO Has any disciplinary action been brought against you which resulted in you being discharged from employment?* YES NO Have you ever served in the Armed Forces of the United States?* YES NO If yes, please list the period of service, rank at the time of discharge and training, and work experience received during service*Have you ever been convicted of any crime (felony or misdemeanor)?** YES NO *Submit official copies of the certificate of disposition. Have you ever had a credential or license revoked, suspended or annulled?* YES NO Have disciplinary proceedings ever been initiated against you pursuant to New York State Education Law Section 3020-a or New York Civil Service Section 75 (or under any other comparable disciplinary provisions relating to public employees)?* YES NO Do you belong to any on-line social networking sites (Facebook, Instagram, Twitter, etc.)?* YES NO If yes, does your profile or other information on such site contain any inappropriate or improper material and/or communications?* YES NO If you answered “Yes” to any of the questions above:please provide the specifics or an explanation for the response. If you elect not to provide specifics, however, or if such an explanation is insufficient, a confidential Investigation will be initiated. None of the above circumstances represents an automatic bar to certification or employment.ConsentConsent* YES - I HAVE READ THIS CAREFULLY AND AGREE I understand that the Hoosick Falls Central School District will be making an extensive inquiry regarding my background and experience and I hereby release from any liability anyone giving information regarding me (whether specifies in my application or not) so long as the information given is relevant to the duties for which I have applied. If requested, I will sign individual releases. I further understand that all information gathered by you regarding my application will be the property of the School District and will not be released to me unless required by federal or state statutes or regulations. I certify that all answers given are true and complete. I authorize the investigation of all statements contained in this application for employment as may be necessary in arriving at an application decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge from the position. I understand also that I am required to abide by all rules and regulations of the employer – Hoosick Falls Central School District. Please note:The Hoosick Falls Central School District is in compliance with federal and state statutes and regulations and does not unlawfully discriminate on the basis of sex, race, creed, national origin, disability, marital status, age or sexual orientation. **** THERE IS A $102.00 PROCESSING FEE FOR FINGERPRINT AND BACKGROUND CHECK PRIOR TO STARTING EMPLOYMENT. **** PhoneThis field is for validation purposes and should be left unchanged.
