Support Application

Today's Date: *

- Month - Day Year
at
: Hour Minutes
Full Name: *

First Name Last Name
E-mail:
Phone Number: *

- Area Code Phone Number
Social Security Num. *
Address: *
How long at address
Applying for Position(s):
Are you authorized to work in the United States

Yes No Uncertain
When can you start?

- Month - Day Year
at
: Hour Minutes
Have you ever worked for Altus Schools

Yes No
If Yes, provided dates of employment, and School Site
Have you ever worked with children?

Yes No
If Yes, explain
Do you have and friends or relatives working for Altus Schools, If yes, please list.
How where you referred to Altus Schools? Please list:
Do you speak a language other than English?

Yes No
If yes, please list all languages in which you speak.
Do you have any physical impairments that would interfere with your job performance?

Yes No
If yes, explain
Have you ever been convicted of a felony?

Yes No
If yes, explain in detail
Do you possess

Computer Skills Typing Skills Other Job Related Skills
Educational Experience: Please list all Schools Attended, Dates Attended, and Degrees Conferred:
Employment History: Please list: Name and Address of Employer, Name of Supervisor, Position, Salary, and Reason for Leaving for the past 10 years:
References: Please list the Name, Address, Occupation, and Phone Number of FOUR Non-Relatives
Upload your resume (optional):
AGREEMENT
Pursuant to Oklahoma State Statute 70: 5-142, the Altus Public Schools will conduct a State (Name) search on all newly employed persons in the district.
I understand that this application will remain active one year after its completion and that I must notify the district, in writing, if I wish to be considered beyond that point.
I authorize investigation of all statement contained in this application. I understand misrepresentation or omission of facts called for is cause for dismissal without notice at any time during my employment.
I agree, if employed, to follow all rules and regulations of the district.
I understand that the Board of Education may require a health certificate from a physician and further understand and agree that the physical will be at my expense.
Applicants Initials *
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AGREEMENT