Father Gabriel Richard High School 4333 Whitehall Drive Ann Arbor ...
Father Gabriel Richard High School 4333 Whitehall Drive Ann Arbor, MI 48105 Phone: (734) 662-0496 Fax: (734) 662-4133 Email: [email protected] Application for Employment Please check all that apply: Full-time Part-time Independent Contractor
Date: _________________________
Please check all that apply: Faculty Staff Coach or Club Moderator
Position(s) Applying For ________________________________________________________________________________________ Areas of Competency English/Literature
(For Faculty Positions):
History
Theology
Fine Arts
Math
Physical Education
Science
World Languages (Specify):___________________________________________
PERSONAL INFORMATION Name: ______________________________________________________________________________________________________ (Last)
(First)
(Middle)
Current Address: ________________________________________________________________________________________________________ (Street)
(City)
(State)
(Zip)
How long have you lived at this address? ________________ Best Contact Number: _________________________ Email Address: ________________________________________
Religion: _____________________________________________
Please list any other names that you have used: _____________________________________________________________________ If hired, can you submit proof that you are over the age of 18 and able to work in the U.S.?
Yes
No
Do you have any physical condition or handicap that may limit your ability to perform the job for which you are applying ? (If yes, please explain in an attached statement.)
Yes
No
Do you believe in God?
Yes
No
Are you comfortable working in an environment where God is the center of all school activities?
Yes
No
Are you a practicing Roman Catholic or, if not, an active member of the religious affiliation listed above?
Yes
No
Can you fully support the teachings of the Roman Catholic Church?
Yes
No
Do you agree that you will not live in any situation or relationship which is in conflict with the teachings and moral principles of the Catholic Church while employed at Father Gabriel Richard?
Yes
No
EDUCATION
Type
Name and Address of School
Course of Study
Years Completed
Diploma/Degree
High School Undergraduate/College Graduate/Professional Other (Specify) Credentials (Include title and state of issuance, date issued, and expiration date.) ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Professional Memberships ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ PREVIOUS EMPLOYMENT Please list the names of your previous employers in chronological order with present or last employer listed first. Immediate supervisors’ names and contact information are required. Be sure to account for all periods of time including military service and any period of unemployment. If self-employed, give company name and supply business references. You may add additional pages if necessary. Employment Dates
Pay Information
____________________________________ Present or Last Employer ____________________________________ Address ____________________________________ City, State, Zip Code ____________________________________ Telephone
________________ From (Month/Year)
$_____________ Starting
____________________ Name & Number of Immediate Supervisor
________________ To (Month/Year)
$_____________ Ending
____________________ ____________________
Pay Information
____________________________________ Previous Employer
____________________________________ City, State, Zip Code
Exact Reason for Leaving
____________________
Employment Dates
____________________________________ Address
Your Title/Position
Your Title/Position ____________________
_______________ From (Month/Year)
$_____________ Starting
____________________ Name & Number of Immediate Supervisor
_______________ To (Month/Year)
$_____________ Ending
___________________________________ Telephone
____________________ ____________________
2
Exact Reason for Leaving
Employment Dates
Pay Information
____________________________________ Previous Employer ____________________________________ Address ____________________________________ City, State, Zip Code
_______________ From (Month/Year)
$_____________ Starting
____________________ Name & Number of Immediate Supervisor
_______________ To (Month/Year)
$_____________ Ending
____________________ ____________________
Employment Dates
Pay Information
____________________________________ Previous Employer
____________________________________ City, State, Zip Code
Exact Reason for Leaving
____________________
___________________________________ Telephone
____________________________________ Address
Your Title/Position
Your Title/Position
Exact Reason for Leaving
____________________ _______________ From (Month/Year)
$_____________ Starting
____________________ Name & Number of Immediate Supervisor
_______________ To (Month/Year)
$_____________ Ending
___________________________________ Telephone
____________________ ____________________
What is your salary expectation for this position? ___________________________________________ Have you ever had a credential or work license denied, suspended, or revoked? If yes, please give date(s) and explain:
Yes
No
Yes
No
Yes
No
Yes
No
____________________________________________________________________________________ Have you ever been suspended, dismissed, or asked to resign from any job? If yes, please give date(s) and explain: ____________________________________________________________________________________ Have you ever been accused of child abuse or any other crime? If yes, please give date(s) and explain: ____________________________________________________________________________________ Have you ever pled guilty to, no contest to, or been convicted of a misdemeanor or felony? If yes, please give date(s) and explain: ____________________________________________________________________________________
3
Please answer the following questions: 1. Why do you want to work at Father Gabriel Richard High School?
2. Please tell us about your faith and relationship with Jesus Christ and the Catholic Church.
3. Please tell us what attracts you to/about your subject area of expertise?
CERTIFICATION I hereby certify that the information presented in this application is true and complete. If hired, I understand that any false statements shall be sufficient cause for dismissal. I authorize investigation of all statements contained in this application. My permission is hereby given to contact any person or organization listed as a current or previous employer and/or my immediate supervisor. I understand and agree that my electronic signature below is and shall have the same force and effect as my original signature. I further agree to re-sign this application at any time if requested by the employer for this position. I agree
I do not agree
____________________________________________ Signature of Applicant (type electronic signature above)
4
__________________________________ Date (month/day/year)
Date: _________________________
Please check all that apply: Faculty Staff Coach or Club Moderator
Position(s) Applying For ________________________________________________________________________________________ Areas of Competency English/Literature
(For Faculty Positions):
History
Theology
Fine Arts
Math
Physical Education
Science
World Languages (Specify):___________________________________________
PERSONAL INFORMATION Name: ______________________________________________________________________________________________________ (Last)
(First)
(Middle)
Current Address: ________________________________________________________________________________________________________ (Street)
(City)
(State)
(Zip)
How long have you lived at this address? ________________ Best Contact Number: _________________________ Email Address: ________________________________________
Religion: _____________________________________________
Please list any other names that you have used: _____________________________________________________________________ If hired, can you submit proof that you are over the age of 18 and able to work in the U.S.?
Yes
No
Do you have any physical condition or handicap that may limit your ability to perform the job for which you are applying ? (If yes, please explain in an attached statement.)
Yes
No
Do you believe in God?
Yes
No
Are you comfortable working in an environment where God is the center of all school activities?
Yes
No
Are you a practicing Roman Catholic or, if not, an active member of the religious affiliation listed above?
Yes
No
Can you fully support the teachings of the Roman Catholic Church?
Yes
No
Do you agree that you will not live in any situation or relationship which is in conflict with the teachings and moral principles of the Catholic Church while employed at Father Gabriel Richard?
Yes
No
EDUCATION
Type
Name and Address of School
Course of Study
Years Completed
Diploma/Degree
High School Undergraduate/College Graduate/Professional Other (Specify) Credentials (Include title and state of issuance, date issued, and expiration date.) ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Professional Memberships ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ PREVIOUS EMPLOYMENT Please list the names of your previous employers in chronological order with present or last employer listed first. Immediate supervisors’ names and contact information are required. Be sure to account for all periods of time including military service and any period of unemployment. If self-employed, give company name and supply business references. You may add additional pages if necessary. Employment Dates
Pay Information
____________________________________ Present or Last Employer ____________________________________ Address ____________________________________ City, State, Zip Code ____________________________________ Telephone
________________ From (Month/Year)
$_____________ Starting
____________________ Name & Number of Immediate Supervisor
________________ To (Month/Year)
$_____________ Ending
____________________ ____________________
Pay Information
____________________________________ Previous Employer
____________________________________ City, State, Zip Code
Exact Reason for Leaving
____________________
Employment Dates
____________________________________ Address
Your Title/Position
Your Title/Position ____________________
_______________ From (Month/Year)
$_____________ Starting
____________________ Name & Number of Immediate Supervisor
_______________ To (Month/Year)
$_____________ Ending
___________________________________ Telephone
____________________ ____________________
2
Exact Reason for Leaving
Employment Dates
Pay Information
____________________________________ Previous Employer ____________________________________ Address ____________________________________ City, State, Zip Code
_______________ From (Month/Year)
$_____________ Starting
____________________ Name & Number of Immediate Supervisor
_______________ To (Month/Year)
$_____________ Ending
____________________ ____________________
Employment Dates
Pay Information
____________________________________ Previous Employer
____________________________________ City, State, Zip Code
Exact Reason for Leaving
____________________
___________________________________ Telephone
____________________________________ Address
Your Title/Position
Your Title/Position
Exact Reason for Leaving
____________________ _______________ From (Month/Year)
$_____________ Starting
____________________ Name & Number of Immediate Supervisor
_______________ To (Month/Year)
$_____________ Ending
___________________________________ Telephone
____________________ ____________________
What is your salary expectation for this position? ___________________________________________ Have you ever had a credential or work license denied, suspended, or revoked? If yes, please give date(s) and explain:
Yes
No
Yes
No
Yes
No
Yes
No
____________________________________________________________________________________ Have you ever been suspended, dismissed, or asked to resign from any job? If yes, please give date(s) and explain: ____________________________________________________________________________________ Have you ever been accused of child abuse or any other crime? If yes, please give date(s) and explain: ____________________________________________________________________________________ Have you ever pled guilty to, no contest to, or been convicted of a misdemeanor or felony? If yes, please give date(s) and explain: ____________________________________________________________________________________
3
Please answer the following questions: 1. Why do you want to work at Father Gabriel Richard High School?
2. Please tell us about your faith and relationship with Jesus Christ and the Catholic Church.
3. Please tell us what attracts you to/about your subject area of expertise?
CERTIFICATION I hereby certify that the information presented in this application is true and complete. If hired, I understand that any false statements shall be sufficient cause for dismissal. I authorize investigation of all statements contained in this application. My permission is hereby given to contact any person or organization listed as a current or previous employer and/or my immediate supervisor. I understand and agree that my electronic signature below is and shall have the same force and effect as my original signature. I further agree to re-sign this application at any time if requested by the employer for this position. I agree
I do not agree
____________________________________________ Signature of Applicant (type electronic signature above)
4
__________________________________ Date (month/day/year)
