Certified Staff Application

PROFESSIONAL PREPARATION
High School (Institution)
City/State
Graduation Year
Bachelors Degree (Institution)
City/State
Graduation Year
Masters Degree (Institution)
City/State
Graduation Year
Doctorate (Institution)
City/State
Graduation Year
Undergraduate
Major Area:
Minor Area:
Graduate
Major Area:
Minor Area:
Grad Hrs Above Highest Degree:
Institution:
TEACHING EXPERIENCE
District Name:
City:
State:
Grade(s) / Subject(s) Taught:
From:

Month Day Year
Date
To:

Month Day Year
Date
Principal/Supervisor Name:
District Name:
City:
State:
Grade(s) / Subject(s) Taught:
From:

Month Day Year
Date
To:

Month Day Year
Date
Principal/Supervisor Name:
District Name:
City:
State:
Grade(s) / Subject(s) Taught:
From:

Month Day Year
Date
To:

Month Day Year
Date
Principal/Supervisor Name:
District Name:
City:
State:
Grade(s) / Subject(s) Taught:
From:

Month Day Year
Date
To:

Month Day Year
Date
Principal/Supervisor Name:
Total Years in Oklahoma
Only Public or Accredited Private School Experience
+
Total Years Out-of-State (5 max)
+
Military Service (5 max)
=
Total Creditable Years Teaching:

REFERENCES
Please include three professional and two personal references.
Professional
Name:
Position:
Relationship to You:
# of Years Acquainted:
Contact Number:
Additional Contact Number:
Address:

Mailing Address

Mailing Address Line 2

City State / Province

Postal / Zip Code Country
Name:
Position:
Relationship to You:
# of Years Acquainted:
Contact Number:
Additional Contact Number:
Address:

Mailing Address

Mailing Address Line 2

City State / Province

Postal / Zip Code Country
Name:
Position:
Relationship to You:
# of Years Acquainted:
Contact Number:
Additional Contact Number:
Address:

Mailing Address

Mailing Address Line 2

City State / Province

Postal / Zip Code Country
Personal
Name:
Position:
Relationship to You:
# of Years Acquainted:
Contact Number:
Additional Contact Number:
Address:

Mailing Address

Mailing Address Line 2

City State / Province

Postal / Zip Code Country
Name:
Position:
Relationship to You:
# of Years Acquainted:
Contact Number:
Additional Contact Number:
Address

Mailing Address

Mailing Address Line 2

City State / Province

Postal / Zip Code Country

Please write a statement listing what you consider to be your major strengths as an educator and how the application of these strengths would be of benefit to the students in your classes. *
***If you are applying for an Administrator position or a Special Education position, please fill out the appropriate supplemental questions on the following pages.***
I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge. I also understand that an employment contract based upon information contained in this application which later proves to be false or incomplete shall result in withdrawal of offer of employment or contract becoming null and void. Glenpool Public Schools is authorized to contact all persons, firms, and entities listed in this application or related papers and/or others who are/were in a position to provide information relevant to the consideration of employment of this applicant. Such persons, firms, and entities are hereby authorized to release any information or records concerning me to the Glenpool School District and I hereby release said persons, firms, and entities from any/all liability as a result of their providing such information or records.
Signature: *

Clear
Date: *

Month Day Year
Date
College Transcript 1
College Transcript 2
Teaching Certificate
Resume

Questions on this page will appear only if you are applying for an Administrator position.
ADMINISTRATOR APPLICANT SUPPLEMENTAL QUESTIONNAIRE
This supplement to the standard application will permit the applicant to express his/her position on issues considered important to an administrative position with Glenpool Schools. Please answer each question as clearly and as concisely as possible. Please relate each response to the administrative position for which you are applying.
Applying for the position of:
Please list previous administrative experience (responsibilities, locations, and length of service in each position). *
1. Describe your preferred leadership style. (Explain or give short examples.) *
2. Please list what you consider to be the five most important characteristics of an exceptional teacher. *
3. Please state your philosophy regarding student discipline and cite methods of discipline that you have used effectively or that you feel would be effective in modifying behavior. *
4. Define curriculum and instruction. What would be your role in regard to these vital educational components? What would be your first action regarding curriculum and instruction? *
5. Please share the role you would take in the following five areas of curriculum and instruction:
A. Academic Standards *
B. Data driven decision making *
C. Teaching *
D. Assessment of student learning *
E. Professional development *
6. Regarding curriculum and instruction, how would you lead your building in creating high expectations for students and determining if they are adequately prepared to exit high school? *

Questions on this page will appear only if you are applying for a Special Education position.
SPECIAL EDUCATION APPLICANT SUPPLEMENTAL QUESTIONNAIRE
1. What is your philosophy in regard to education for children with disabilities? *
2. What is your definition of least restrictive environment? *
3. What is your definition of inclusion? *
4. What roles does the special educator play in providing the least restrictive environment for students with disabilities? *
5. List the materials, techniques, and assessment instruments you would use in establishing your program for elementary/middle/secondary. Focus on the grade level for which you are applying. *
6. What would you do to enhance and maintain your expertise in the field of special education? *

AREAS OF CERTIFICATION

(As you scroll through each list, hold down the Ctrl key and click on all that apply.)
0500 Prof School Services
1000 Elementary Education
2000 Elem-Secondary Edu
2500 Special Education
3500 Business
3700 Foreign Language
4000 English/Language Arts
4500 Home Economics
5000 Industrial Arts
5500 Mathematics
6000 Science
6500 Social Studies
7000 Specialized Service
7500 Career & Tech Edu
8000 Special Endorsements
8500 Technology Education
9800 Special Education

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