1 3 2 4+ Licensure/Skills License Number: If you are applying for a teaching position, Yes If yes, for what do you hold an Indiana School Teaching No grade level? Expiration License? N/A Date: List current licenses/certifications that are relevant to the position for which you are applying (please provide copies) List any training that is relevant to the position for which you are applying List any skills and/or qualifications that are relevant to the position for which you are applying Fluent Good Fair Speak List any languages that you are able to speak, read, and/or write. Read Write GENERAL INFORMATION Have you ever been employed Yes If yes, give dates of From: To: by Cathedral High School? No employment Do you have any friends or Yes If yes, what are their family who are currently No name(s) employed by us? How were you referred to Cathedral High School? Yes Yes Are you baptized Catholic? Are you currently a practicing Catholic? No No If yes, what is the name of your parish? If no, what is your religion of preference? Are you less than 18 years old? Yes (Proof of age may be required after a job offer) No Are you able to travel if required by Yes Driver’s License Number: the position? No Have you ever been convicted of a felony or misdemeanor? Yes (A conviction does not constitute an automatic bar to employment) No
1 3 2 4+ Licensure/Skills If you are applying for a teaching position, do you hold an Indiana School Teaching License? Yes No N/A If yes, for what grade level? License Number: Expiration Date: List current licenses/certifications that are relevant to the position for which you are applying (please provide copies) List any training that is relevant to the position for which you are applying List any skills and/or qualifications that are relevant to the position for which you are applying List any languages that you are able to speak, read, and/or write. Fluent Good Fair Speak Read Write GENERAL INFORMATION Have you ever been employed by Cathedral High School? Yes No If yes, give dates of employment From: To: Do you have any friends or family who are currently employed by us? Yes No If yes, what are their name(s) How were you referred to Cathedral High School? Are you baptized Catholic? Yes No Are you currently a practicing Catholic? Yes No If yes, what is the name of your parish? If no, what is your religion of preference? Are you less than 18 years old? (Proof of age may be required after a job offer) Yes No Are you able to travel if required by the position? Yes No Driver’s License Number: Have you ever been convicted of a felony or misdemeanor? (A conviction does not constitute an automatic bar to employment) Yes No
Employment_Application--Revised_4-8-2010.docx