of alleged misconduct? Yes No Documentation Previously Provided on This Item □ □ □ 4. Is any action now pending against you for alleged misconduct in any school district, or before any agency? Yes No Documentation Previously Provided on This Item □ □ □ 5. Have you ever been convicted of or are you currently under indictment for a felony? Yes No Documentation Previously Provided on This Item □ □ □ 6. Have you ever been convicted of or are you currently under indictment for a misdemeanor? (For purposes of this application, traffic citations should not be reported.) Arrests or convictions for driving while intoxicated (DWI) or driving under the influence of alcohol or other drugs (DUI) must be reported. Yes No Documentation Previously Provided on This Item □ □ □ Oath: I, ___________________________________, swear or affirm under the penalty of perjury that all information provided in or with this application is true, correct, and complete to the best of my knowledge. I understand that any false statements, misrepresentations, or omissions of fact in or with this application are grounds for denial, suspension, or revocation of the license(s) that I am seeking. _____________________________________________________________________________________ Signature of Applicant Date Applicant Self-Appraisal Please rate yourself in the following areas of job requirements. Use the following scale: 5 Strong; 4 Fairly Strong; 3 Average: 2 Somewhat Weak: 1 Weak – – – – – Area 5 4 3 2 1 Planning and Preparation Organization and Management Instructional Techniques Discipline Techniques Willingness to Handle Duties Please use the space below to make a personal statement about yourself, your qualifications, and your future plans and objectives.
of alleged misconduct? □ Yes □ No □ Documentation Previously Provided on This Item 4. Is any action now pending against you for alleged misconduct in any school district, or before any agency? □ Yes □ No □ Documentation Previously Provided on This Item 5. Have you ever been convicted of or are you currently under indictment for a felony? □ Yes □ No □ Documentation Previously Provided on This Item 6. Have you ever been convicted of or are you currently under indictment for a misdemeanor? (For purposes of this application, traffic citations should not be reported.) Arrests or convictions for driving while intoxicated (DWI) or driving under the influence of alcohol or other drugs (DUI) must be reported. □ Yes □ No □ Documentation Previously Provided on This Item Oath: I, ___________________________________, swear or affirm under the penalty of perjury that all information provided in or with this application is true, correct, and complete to the best of my knowledge. I understand that any false statements, misrepresentations, or omissions of fact in or with this application are grounds for denial, suspension, or revocation of the license(s) that I am seeking. _____________________________________________________________________________________ Signature of Applicant Date Applicant Self-Appraisal Please rate yourself in the following areas of job requirements. Use the following scale: 5 – Strong; 4 – Fairly Strong; 3 – Average: 2 – Somewhat Weak: 1 – Weak Area 5 4 3 2 1 Planning and Preparation Organization and Management Instructional Techniques Discipline Techniques Willingness to Handle Duties Please use the space below to make a personal statement about yourself, your qualifications, and your future plans and objectives.
teacher_application_july_2015__1_.docx