PERSONAL INFORMATION
Date of Application:
Date Available for Employment: - -
Part Time
Full Time
Position Applying for
 
Email
   
Name
Last Name
 First Name
 Middle Name
 
Address Street
City
 State
 Zip
 
Telephone
Are you related to a member of RES's Board Yes  No
How did you hear about us?
What campus are you interested in?
   
EDUCATIONAL BACKGROUND
Name of Institution City & State Major Field of Study Minor Field of Study Degree/Hrs. Earned
High School
College/University
 
STUDENT TEACHING/PROFESSIONAL EXPERIENCE
School District & Campus Grade/Subject Dates Taught From-To Supervisor/Principal Reason for Leaving
   
Total Years of Teaching Experience:
   
 
CERTIFICATE & LICENSE INFORMATION
Type of Certificate/License (Attach a copy) Areas of Specialization Dates Issued Expiration Date State
 
OTHER WORK EXPERIENCE
Company Address and Phone Job Title & Salary Dates Employed From-To Supervisor Reason for Leaving
 
PROFESSIONAL INFORMATION
Publications/Articles:
Professional Organizations:
Seminars/Workshops Conducted:
   
GENERAL INFORMATION
Current monthly salary:
Salary needed to work in a Responsive Education Solutions LearningCenter:
Have you ever been (1) arrested (2)convicted of, or (3) pled guilty, or (4) pled no contest (nolo contender) to a felony or misdemeanor other than a minor traffic violation? Yes  No
If YES, please explain:
   

Have you ever been asked to resign or been terminated through due process from any position?

 Yes  No
If YES, please explain:
   
 
REFERENCES
Please list two work related references and three personal references that may be contacted regarding character and work history.
Name Position/Relationship School District/Company Area Code & Telephone#
   
PERSOANL STATEMENT

Please make a statement concerning your reasons for desiring a position with the Responsive Education Solutions.  Give additional information about your background, training, experience, and future plans that would be pertinent to your application (use additional sheets of paper if necessary).
 
ACKNOWLEDGEMENTS:

I understand that the position for which I am applying is considered at-will, which means either Responsive Education Solutions, or I can terminate employment for any reason or no reason at any time. 

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge.  I understand that, if employed, any falsified information may be considered sufficient cause for dismissal.  Responsive Education Solutions is authorized to make an investigation of my education and work history and may contact the references listed.
I Agree
 

Responsive Education Solutions is an equal opportunity employer and does not discriminate on any basis prohibited or protected by federal or state law including race, color, disability, sex, religion, age, or national origin.
   
 
         
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