GUNTER INDEPENDENT SCHOOL
DISTRICT
We consider applicants for all positions without regard to
race, color, national origin, age, religion, sex, marital status, veteran or
military status, the presence of a medical condition, disability, or any other
legally protected status.
Date
of application_______________________________ Social Security number____________________
Name_________________________________________________________________________________
Last First Middle
Initial
Current
Address_______________________________________________________________________________
Other
address where you may be reached_____________________________________________________
Work
phone______________________________ Home phone___________________________________
Other
name that may appear on records______________________________________________________
(Used only for reference
checks)
List
the position(s) you are applying for______________________________________________________
Type
of employment: _____Full-time _____Part-time _____Summer only
Date
you can begin work_________________________
Have
you been employed by Gunter ISD in the past? _____Yes _____No
If
you answered yes, provide dates of employment_________________________
Check
the highest level of education attained:
_____Not
a high school graduate (circle last grade completed) 1 2 3
4 5 6 7
8 9 10 11 12
_____High
school graduate _____GED _____Less than two years of college
_____Two
of more years of college _____Bachelor’s
degree _____Master’s
degree
_____Other
training or education___________________________________________________________
Licenses
and certificates held______________________________________________________________
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Name
and location of schools attended |
Course
of study And
major/minor |
Diploma,
degree, certificate, or license
held |
Year
graduated (College
only) |
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Please
provide a complete list of all positions you have held in the past 10
years. List the most recent first. Attach additional sheets if necessary (bus
driver applicants, see addendum).
Attach resume if available.
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Employer
and location |
Position/title |
Dates
employed |
Reason
for leaving |
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List specific skills and any machines or equipment
you can operate. Include typing speed
and number of years of experience.
1.______________________________ 2.______________________________
3.______________________________ 4.______________________________
5.______________________________ 6.______________________________
Do you have a relative who serves on the Gunter ISD
Board of Education? _____Yes _____No
If yes, please provide the relative’s name and
relationship:______________________________________
Have you ever been convicted of or plead guilty or
no contest (nolo contendre) to a felony or offense involving moral turpitude
(including, but no limited to, theft, rape, murder, swindling, and indecency
with a minor)?_____Yes_____No
If yes, please state where, when, and the nature of
the offense; indicate whether the charges were dismissed as a condition of
probation, suspension, or deferred adjudication:
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
(A felony
conviction is not an automatic bar to employment. The district will consider the nature, date, and relationship
between the offense and the position for which you are applying.)
Please
list references the district can contact regarding your work history. Please include all managers and supervisors
who evaluated or supervised your performance at your last two employers.
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Full
name of reference |
School
district/firm name |
Mailing
address |
Position/title |
Area
code/phone number |
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I
hereby affirm that all information provided in this application is true and accurate
to the best of my knowledge and understand that any deliberate falsifications,
misrepresentations, or omissions of fact may be grounds for rejection of my
application or dismissal from subsequent employment.
I
authorize the references listed above to give you any and all information
concerning my previous employment and any pertinent information they may have,
personal or otherwise, and release all such parties from liability for any
damage that may result from furnishing the same to you.
I understand
that the district is authorized by Texas Education Code 22.083 to obtain
criminal history record information on applicants the district intends to
employ.
_______________________________________________________________________
Signature Date
This application becomes the property of the
district. The district reserves the
right to accept or reject it. This
application shall be considered active for a period not to exceed 365
days. Any applicant wishing to be
considered for employment beyond this time period may inquire as to whether or
not applications are being accepted at that time.
________________________________________________________________
CONSENT TO PERFORM CRIMINAL HISTORY BACKGROUND CHECK
IN COMPLIANCE WITH THE FCRA (FAIR CREDIT REPORTING
ACT)
Last
Name First
Name Middle
Initial
Maiden
and/or Other Names Used
City** County** State**
Date
of Birth Social
Security Number
I,
______________________________, am an applicant for employment with the Gunter
ISD
The
district has informed me that I have the right to review and challenge any negative
information that would adversely impact a decision to offer employment. In addition, I have been informed that I
will have a reasonable opportunity to clear up any mistaken information
reported within a reasonable time frame established within the sole discretion
of the district. Under the Fair Credit
Reporting Act, I have been advised that upon request I will be provided the
name, address and telephone number of the reporting agency as well as the
nature, substance and source of all information.
The
following are my responses to questions about my criminal record history (if
any) with descriptions to any question with a YES answer:
1. Have you ever been convicted or plead guilty
before a court of any federal, state, or municipal criminal offense? (Excluding
minor traffic violations) _____Yes _____No
If
YES, Please provide an explanation below:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. Have you ever received deferred adjudication
or similar disposition for any federal, sate or municipal criminal offense? _____Yes _____No
If
YES, Please provide an explanation below:
_____________________________________________________________________________________
_____________________________________________________________________________________
3. Have you ever
received probation or community supervision for any federal, state or municipal
criminal offense? _____Yes _____No
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
If
YES, Please provide an explanation below:
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
THIS
SECTION IS TO BE USED TO LIST ALL COUNTIES AND STATES OF RESIDENCE SINCE AGE 18
OR HIGH SCHOOL GRADUATION.YOU MUST BE SPECIFIC ABOUT DATES OF RESIDENCE.
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CITY/TOWN |
COUNTY |
STATE |
DATES FROM |
TO |
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I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IN THIS
AUTHORIZATION IS TRUE, CORRECT AND COMPLETE.I UNDERSTAND THAT IF ANY
INFORMATION PROVES TO BE INCORRECT OR INCOMPLETE THAT GROUNDS FOR THE CANCELING
OF ANY AND ALL OFFERS OF EMPLOYMENT WILL EXIST AND MAY BE USED AT THE
DISCRETION OF THE DISTRICT.
Signed
this______________________________day of____________________ , 20__________
APPLICANT
(Print Name)_______________________________________________________
APPLICANT’S
SIGNATURE_____________________________________________________