Substitute Teacher Application

Columbia Academy Substitute Teacher Application:

If you would like to upload your resume, please do it here.
(allowed file types: )
* Name (First Name, Middle Name, Last Name):
Maiden Name (if applicable):
* Address:
* City, State, Zip:
* Telephone Number:
Position(s) applied for:
Preschool   JrK - 2nd   3rd - 6th   7th - 12th
* Day(s) available to work:
(1 required)
M   Tues   W   Thurs   F
* Day you are available to start work:
* Church Membership, Home Congregation:
* Congregation City/State:
* Do you drink alcohol?
* Do you use tobacco?
* Have you ever been convicted of a crime (other than a minor traffic violation)?
Yes   No
If yes, list convictions: (A conviction does not necessarily disqualify an applicant for the position).

EDUCATION

* Name and Location of High School
Name and Location of College/University
College Course of Study

WORK EXPERIENCE:

#1 Employer:
City/State:
Employer Phone:
Duties:
#2 Employer:
City/State:
Employer Phone:
Duties:

REFERENCES:

* Type of Reference:
Professional   Personal
* Name:
* Organization:
* Relationship:
City/State:
* Years Known:
* Phone:
* Email:
* Type of Reference:
Professional   Personal
* Name:
* Organization:
* Relationship:
City/State:
* Years Known:
* Phone:
* Email:

ADDITIONAL INFORMATION

TN Teacher Certificate Number:
Date Issued:
Date Expires:

The information submitted is true and complete to the best of my knowledge.  Should I be employed by the School, any misrepresentation or false statement contained herein may be considered cause for possible dismissal.  The School, in compliance with the provisions of the Fair Credit Reporting Act of Sept. 1997, may contact directly or employ the services of investigative agencies to obtain all necessary information from the references I have listed, or any other sources, concerning my prior employment, personal history, or credit standing.  I reserve the right to know the names and addresses of any investigative agencies used in order that I may learn the information contained in any reports furnished to the School.

I understand this application does not constitute an employment contract of any kind. 

I understand that a separate Background Search Consent Form may be required.

ELECTRONIC SIGNATURE

The electronic signature and related fields below are treated by Columbia Academy like a physical handwritten signature on a paper form.

* Check for electronic signature
(1 required)
Yes
* Name:
* Date:
* Email Address: