Job Application Form - Certified (Licensed) Employment Application

CERTIFIED (LICENSED) EMPLOYMENT APPLICATION 2020-2021

Please complete the form below to apply for this position.
Date*

MonthDayYear
Full Name*

First NameMiddle NameLast Name
Position sought*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email Address*
Driver License #*
Colorado Teaching License #*
License Type*
Endorsement(s)
Expiration*
Content Exam: Have you passed a CDE approved PLACE or PRAXIS exam?*

YesNo
Please complete the following sections:

Please complete the following sections. Incomplete applications or applications using "Please see resume" will not be considered.

EDUCATION*

	College/University	Dates	Semester Hrs	Degree

Degree*

	Major	Minor	Grade Point Avg:
Degree 1
Degree 2

# of Semester Hrs*

	Education	Special Education	Other

Student Teaching:*
School/ City State Zip
List college activities and/or honors received:*
List athletics/activities you are interested in coaching/sponsoring:*
List professional/civic organizations and activities:*
Briefly state why you are seeking this position:*

PREVIOUS TEACHING EXPERIENCE*

	Employing School District	Dates	Position	Grade Level/Subject	Reason for Leaving

REFERENCES*

	Name	Address	Phone	Relationship

Are you eligible for employment in the United States?*

YesNo
Are you presently employed?*

YesNo
If employed, may we inquire of your present employer?*

YesNo
Have you ever been involuntarily terminated from any employment? *

YesNo
If yes, please explain:
Has any court ever received a plea of guilty or a plea of nolo contendere from you for any offense, deferred further proceedings without entering a finding of guilty, and/or placed you on probation?*

YesNo
if yes, please explain:
Have you ever been convicted of a felony or child abuse?*

YesNo
If yes, please explain:
Have you ever been convicted of, pled nolo contendere to, or received a deferred sentence for a crime involving unlawful behavior or unlawful sexual behavior involving a child?*

YesNo
If yes, please explain:
I DO INTEND to assert my portability right as a non-probationary teacher if hired for this position and will provide Manitou Springs School District 14 documented evidence of my two (2) consecutive effectiveness ratings within thirty (30) days of hire.

I DO INTEND
I DO NOT INTEND to assert my portability right as a non-probationary teacher if hired for this position.

I DO NOT INTEND
I have been informed of and understand the requirements of the position for which I am applying. I represent that I am capable of performing the physical requirements of this position as described.

I grant my prospective employer full authority to verify the information on this application via driver’s record, worker’s compensation, criminal history, index, and registry files. I certify that the information provided by me on this application is true and correct to the best of my knowledge. I understand that false statements on this application, including false statements regarding my physical abilities, may result in termination of employment.
Signature*

Clear
Manitou Springs School District 14 is an equal opportunity educational institution and will not discriminate on the basis of race, color, national origin, ancestry, creed, religion, sex (which includes marital status), sexual orientation, disability, age, genetic information or conditions related to pregnancy or childbirth in its activities, programs or employment practices as required by Title VI, Title I, and Section 504. For information regarding civil rights or grievance procedures, contact Dr. Elizabeth Domangue, Superintendent of Schools, Manitou Springs School District 14, 405 El Monte Pl., Manitou Springs, CO 80829, (719) 685-2024, edomangue@mssd14.org or the Office of Civil Rights, U.S Dept of Education, 1961 Stout Street, Denver, CO 80294, (303) 844-2991.
To complete your application packet, please include application, cover letter, current resume, letters of recommendation (3), copy of current transcripts, copy of PLACE/PRAXIS results, and copy of Colorado teaching license.
APPLICATIONS ARE KEPT ON FILE FOR TWO YEARS FROM
DATE OF SIGNATURE
Upload cover letter as a pdf

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Upload resume as a pdf

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Upload letter of recommendation as a pdf*

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Upload letter of recommendation as a pdf

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Upload letter of recommendation as a pdf

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Current transcripts as a pdf*

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Current transcripts as a pdf

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Maximum file size is 2 MB. File must be in PDF format. Cancelof
Upload a copy of PLACE and/or PRAXIS results as a pdf file

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Copy of Colorado teaching license as a pdf*

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CERTIFIED (LICENSED) EMPLOYMENT APPLICATION 2020-2021

Please complete the following sections: