King's Academy Christian School
King’s Academy Christian School “Education in the Presence of God” A University-Model School®
Application for Employment – Section 1 Revised 10-12-2012
PLEASE PRINT
Application Date____________
A. APPLICANT’S CONTACT INFORMATION Last Name Middle Name First Name Social Security #
Email
County of residence
Street Address Day Phone
Maiden name
Evening Phone
City
State
Zip
Cell Phone
Date of Birth
Gender
B. POSITION INFORMATION Date Available to start
Desired Hourly Wage
Are you employed now?
If yes, may we inquire your present employer?
Position Seeking (check all that applies) Teaching: ______Substitute: _________ Elementary __________Middle School (7-8) ____________ High School (9-12) __________________Desired Subject Area: ________________ C. EDUCATIONAL / PROFESSIONAL QUALIFICATIONS Did you earn a high School Diploma? ______Yes _____No Name used on School Records Type of School College
Name & Address of School
Degree
Major Subject
Minor Subject
Graduate School Tech., Business, or Other Highest degree earned: ___________________________ Teacher Certification in: _______________________ Graduate semester hours earned after highest degree: _____________________________________________ Number of years of formal classroom teaching experience ________ (Do not include student teaching, tutoring, co-op classes, etc.)
604. W. 4th Street• Tyler, Texas 75701 • Phone: 903.534.9992 • Fax: 903.526.7929 • Website: www.kacs.net Page 1 of 6
D. EMPLOYMENT HISTORY Start with your present or most recent position. Include experience in the Armed Forces of the U.S. Please feel free to attach additional information, such as a resume. Name of Present or Last Employer Address
City
State
Starting Date
End Date
Job title
Weekly / Monthly Starting Salary
Final Salary
May we contact your supervisor?
Name of Supervisor
Zip
Title
Phone
Zip
Description of work Reason for leaving OFFICE USE ONLY
Reference checked
Name of Present or Last Employer Address
City
State
Starting Date
End Date
Job title
Weekly / Monthly Starting Salary
Final Salary
May we contact your supervisor?
Name of Supervisor
Title
Phone
Zip
Description of work Reason for leaving OFFICE USE ONLY
Reference checked
Name of Present or Last Employer Address
City
State
Starting Date
End Date
Job title
Weekly / Monthly Starting Salary
Final Salary
May we contact your supervisor?
Name of Supervisor
Title
Description of work Reason for leaving OFFICE USE ONLY
Reference checked
Phone
E. STATEMENT OF FAITH In your own handwriting on a separate sheet, briefly share your Christian testimony. Bible - Do you believe the Bible to be the only inspired and infallible Word of God, our final authority of faith, truth and conduct? F. CHURCH MEMBERSHIP Name of the church Are you a member?
Number of years?
Pastor’s name
What church or community activities and service are you involved and with what degree of regularity?
G. PROFESSIONAL ORGANIZATIONS AND ACTIVITIES (CIVIC, ATHLETICS, ETC.)
H. GENERAL; PLEASE LIST ANY SPECIFIC STUDY OR RESEARCH WORK, SPECIAL TRAINING OR SKILLS ___________________________________________________________________________________ 9 I. SERVICE RECORD Branch of service
Rank
Discharge date
J. PERSONAL PHILOSOPHY Please answer the following questions on a separate paper: 1. Why do you want to teach in a Christian school, and specifically at King’s Academy Christian School? Comment on the mission statement of King’s Academy Christian School. 2. What does teaching from a Christian world view mean to you? 3. Describe your teaching style and how you motivate students to learn. 4. What is your philosophy of discipline? 5. What are your greatest strengths and your greatest weaknesses as a teacher / aide? K. PERSONAL REFERENCES Give references that are qualified to speak of your spiritual experience, Christian service, and character. Do not list family members or relatives for references. Name 1. 2.
Complete address
Phone number
Position
Application for Employment – Section 2 PERSONAL INFORMATION MARITAL 1. Being a Christian role model in all aspects of life is a major requirement for this position. The Bible is our standard for marriage and sexual conduct. It is a bona fide occupational requirement for staff to live by those standards. Please indicate your current marital status. Single: _______ Engaged: _______ Married: _______ Separated: _____ Divorced: _____ Re-married: _____ Widow(er): _____ Please attach explanation if divorced or remarried. Spouse’s name _______________________________________ Years married ____________________________ Occupation ___________________________________________________________________________________ PERSONAL 1. Have you ever been charged in civil or criminal proceedings with improprieties regarding children? Yes ___ No ___ 2. Have you ever entered a court plea of guilty, a court plea of “no contest” (nolo contendere), or has any court ever deferred further proceedings without entering a finding of guilty and placed you on probation or in a public service or education program for any crime other than a minor traffic offense? Yes ___ No ___ How did you hear about King’s Academy? _________________________________________________________ __________________________________________________________________________________________________ JOB FUNCTIONS 1. You have read the job description and essential functions for this position. Is there any reason why you might be unable to perform the duties and responsibilities of the position for which you are applying? Yes ___ No ___ If yes, please explain: _________________________________________________________
________________________________________________________________________________________ 2. If you answered "yes" to above question, is there anything that the school can do to reasonably accommodate your needs so that you would be qualified to perform the duties and responsibilities of this position? ____________________________________________________________________________________
________________________________________________________________________________________ 3. If you are offered a position, will you be able to verify that you are legally permitted to be employed in the United States? Yes ___ No ___ If No, please explain: ____________________________________________
________________________________________________________________________________________ ________________________________________________________________________________________ 4. Have you ever been convicted of the crime of moral turpitude? Yes ___ No ___ If yes, please explain:
________________________________________________________________________________________ ________________________________________________________________________________________ 5. Have you ever been convicted of a felony? Yes ___ No ___ If yes, please explain: ___________________
________________________________________________________________________________________ ________________________________________________________________________________________ 6. Can you work the hours required for the job? Yes ___ No ___ If no, please explain: __________________
________________________________________________________________________________________
7. Do you have any complaints filed with the credentialing organization of any states? ____ If yes, please explain: _____________________________________________________________________________________
________________________________________________________________________________________ CURRENT ISSUES 1. We live in a pluralistic society with many conflicting beliefs and values. As a teacher you may be asked specific questions about controversial issues by your students. Your answers will come from your personal convictions. We need to know the views of those that would be Christian role models for our children. Please share your personal convictions as a Christian toward: Alcoholic beverages, smoking and chewing tobacco__________________________________________________ _____________________________________________________________________________________________ Illegal drugs __________________________________________________________________________________ _____________________________________________________________________________________________ Entertaining (music / dancing) __________________________________________________________________ _____________________________________________________________________________________________ Pre-marital sex _______________________________________________________________________________ _____________________________________________________________________________________________ Divorce and remarriage ________________________________________________________________________ _____________________________________________________________________________________________ Abortion _____________________________________________________________________________________ _____________________________________________________________________________________________ Homosexuality ________________________________________________________________________________ _____________________________________________________________________________________________ Personal debt _________________________________________________________________________________ _____________________________________________________________________________________________ Gossip _______________________________________________________________________________________ _____________________________________________________________________________________________ Lying ________________________________________________________________________________________ _____________________________________________________________________________________________ Cheating _____________________________________________________________________________________ _____________________________________________________________________________________________
I certify that the facts contained are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. Signature ___________________________________________________________ Date _____________________ DECLARATION OF MORAL INTEGRITY As an applicant for employment or for a volunteer position with unsupervised access to children at King’s Academy Christian School of Tyler, and its ministries, I recognize, understand, and agree to live by the moral standards of the school. I further declare that with regard to my personal moral character and conduct, I will not engage in inappropriate conduct, including, but not limited to, such behaviors as the following: adult heterosexual activity outside of marriage commitment; homosexual or lesbian inclinations or actions; or sexual abuse or improprieties toward minors as defined by Scripture and state law; or any activity that would undermine my position as a Christian role model for children. I do declare that the above statement is factual and true. By affixing my signature, I declare that I meet the moral integrity standards and Christian role model lifestyle requirements of King’s Academy Christian School. Applicant’s Signature _________________________________________________ Date _____________________ Administrator’s Signature _____________________________________________ Date _____________________ Please sign the above in the presence of the Administrator. CRIMINAL BACKGROUND INVESTIGATION: Consent to Perform Criminal History Background Check and Advising of Rights Under the Fair Credit Reporting Act
I, ____________________________________, am an applicant for employment with King’s Academy Christian School. I have been advised that as a part of the application process, King’s Academy may conduct a criminal history background check. I, ____________________________________, do hereby consent to King’s Academy Christian School use of any information provided during the application process in performing the criminal history background check. I have been informed by King’s Academy Christian School that I have the right to review and challenge any negative information that would adversely impact King’s Academy Christian decision to offer employment. I have also been advised that King’s Academy Christian School will give me a reasonable opportunity to clear up any mistaken information reported. However, I do understand that time is of the essence and reasonableness of time is within the sole discretion of King’s Academy Christian School. King’s Academy Christian School has informed me that under the Fair Credit Reporting Act, I have certain rights concerning my review of the information reported. I will be provided the name, address, and telephone number of the reporting agency, as well as the nature and substance of all information and the source. List previous addresses not shown on application City/Town County
State
From
To
Application for Employment – Section 1 Revised 10-12-2012
PLEASE PRINT
Application Date____________
A. APPLICANT’S CONTACT INFORMATION Last Name Middle Name First Name Social Security #
County of residence
Street Address Day Phone
Maiden name
Evening Phone
City
State
Zip
Cell Phone
Date of Birth
Gender
B. POSITION INFORMATION Date Available to start
Desired Hourly Wage
Are you employed now?
If yes, may we inquire your present employer?
Position Seeking (check all that applies) Teaching: ______Substitute: _________ Elementary __________Middle School (7-8) ____________ High School (9-12) __________________Desired Subject Area: ________________ C. EDUCATIONAL / PROFESSIONAL QUALIFICATIONS Did you earn a high School Diploma? ______Yes _____No Name used on School Records Type of School College
Name & Address of School
Degree
Major Subject
Minor Subject
Graduate School Tech., Business, or Other Highest degree earned: ___________________________ Teacher Certification in: _______________________ Graduate semester hours earned after highest degree: _____________________________________________ Number of years of formal classroom teaching experience ________ (Do not include student teaching, tutoring, co-op classes, etc.)
604. W. 4th Street• Tyler, Texas 75701 • Phone: 903.534.9992 • Fax: 903.526.7929 • Website: www.kacs.net Page 1 of 6
D. EMPLOYMENT HISTORY Start with your present or most recent position. Include experience in the Armed Forces of the U.S. Please feel free to attach additional information, such as a resume. Name of Present or Last Employer Address
City
State
Starting Date
End Date
Job title
Weekly / Monthly Starting Salary
Final Salary
May we contact your supervisor?
Name of Supervisor
Zip
Title
Phone
Zip
Description of work Reason for leaving OFFICE USE ONLY
Reference checked
Name of Present or Last Employer Address
City
State
Starting Date
End Date
Job title
Weekly / Monthly Starting Salary
Final Salary
May we contact your supervisor?
Name of Supervisor
Title
Phone
Zip
Description of work Reason for leaving OFFICE USE ONLY
Reference checked
Name of Present or Last Employer Address
City
State
Starting Date
End Date
Job title
Weekly / Monthly Starting Salary
Final Salary
May we contact your supervisor?
Name of Supervisor
Title
Description of work Reason for leaving OFFICE USE ONLY
Reference checked
Phone
E. STATEMENT OF FAITH In your own handwriting on a separate sheet, briefly share your Christian testimony. Bible - Do you believe the Bible to be the only inspired and infallible Word of God, our final authority of faith, truth and conduct? F. CHURCH MEMBERSHIP Name of the church Are you a member?
Number of years?
Pastor’s name
What church or community activities and service are you involved and with what degree of regularity?
G. PROFESSIONAL ORGANIZATIONS AND ACTIVITIES (CIVIC, ATHLETICS, ETC.)
H. GENERAL; PLEASE LIST ANY SPECIFIC STUDY OR RESEARCH WORK, SPECIAL TRAINING OR SKILLS ___________________________________________________________________________________ 9 I. SERVICE RECORD Branch of service
Rank
Discharge date
J. PERSONAL PHILOSOPHY Please answer the following questions on a separate paper: 1. Why do you want to teach in a Christian school, and specifically at King’s Academy Christian School? Comment on the mission statement of King’s Academy Christian School. 2. What does teaching from a Christian world view mean to you? 3. Describe your teaching style and how you motivate students to learn. 4. What is your philosophy of discipline? 5. What are your greatest strengths and your greatest weaknesses as a teacher / aide? K. PERSONAL REFERENCES Give references that are qualified to speak of your spiritual experience, Christian service, and character. Do not list family members or relatives for references. Name 1. 2.
Complete address
Phone number
Position
Application for Employment – Section 2 PERSONAL INFORMATION MARITAL 1. Being a Christian role model in all aspects of life is a major requirement for this position. The Bible is our standard for marriage and sexual conduct. It is a bona fide occupational requirement for staff to live by those standards. Please indicate your current marital status. Single: _______ Engaged: _______ Married: _______ Separated: _____ Divorced: _____ Re-married: _____ Widow(er): _____ Please attach explanation if divorced or remarried. Spouse’s name _______________________________________ Years married ____________________________ Occupation ___________________________________________________________________________________ PERSONAL 1. Have you ever been charged in civil or criminal proceedings with improprieties regarding children? Yes ___ No ___ 2. Have you ever entered a court plea of guilty, a court plea of “no contest” (nolo contendere), or has any court ever deferred further proceedings without entering a finding of guilty and placed you on probation or in a public service or education program for any crime other than a minor traffic offense? Yes ___ No ___ How did you hear about King’s Academy? _________________________________________________________ __________________________________________________________________________________________________ JOB FUNCTIONS 1. You have read the job description and essential functions for this position. Is there any reason why you might be unable to perform the duties and responsibilities of the position for which you are applying? Yes ___ No ___ If yes, please explain: _________________________________________________________
________________________________________________________________________________________ 2. If you answered "yes" to above question, is there anything that the school can do to reasonably accommodate your needs so that you would be qualified to perform the duties and responsibilities of this position? ____________________________________________________________________________________
________________________________________________________________________________________ 3. If you are offered a position, will you be able to verify that you are legally permitted to be employed in the United States? Yes ___ No ___ If No, please explain: ____________________________________________
________________________________________________________________________________________ ________________________________________________________________________________________ 4. Have you ever been convicted of the crime of moral turpitude? Yes ___ No ___ If yes, please explain:
________________________________________________________________________________________ ________________________________________________________________________________________ 5. Have you ever been convicted of a felony? Yes ___ No ___ If yes, please explain: ___________________
________________________________________________________________________________________ ________________________________________________________________________________________ 6. Can you work the hours required for the job? Yes ___ No ___ If no, please explain: __________________
________________________________________________________________________________________
7. Do you have any complaints filed with the credentialing organization of any states? ____ If yes, please explain: _____________________________________________________________________________________
________________________________________________________________________________________ CURRENT ISSUES 1. We live in a pluralistic society with many conflicting beliefs and values. As a teacher you may be asked specific questions about controversial issues by your students. Your answers will come from your personal convictions. We need to know the views of those that would be Christian role models for our children. Please share your personal convictions as a Christian toward: Alcoholic beverages, smoking and chewing tobacco__________________________________________________ _____________________________________________________________________________________________ Illegal drugs __________________________________________________________________________________ _____________________________________________________________________________________________ Entertaining (music / dancing) __________________________________________________________________ _____________________________________________________________________________________________ Pre-marital sex _______________________________________________________________________________ _____________________________________________________________________________________________ Divorce and remarriage ________________________________________________________________________ _____________________________________________________________________________________________ Abortion _____________________________________________________________________________________ _____________________________________________________________________________________________ Homosexuality ________________________________________________________________________________ _____________________________________________________________________________________________ Personal debt _________________________________________________________________________________ _____________________________________________________________________________________________ Gossip _______________________________________________________________________________________ _____________________________________________________________________________________________ Lying ________________________________________________________________________________________ _____________________________________________________________________________________________ Cheating _____________________________________________________________________________________ _____________________________________________________________________________________________
I certify that the facts contained are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. Signature ___________________________________________________________ Date _____________________ DECLARATION OF MORAL INTEGRITY As an applicant for employment or for a volunteer position with unsupervised access to children at King’s Academy Christian School of Tyler, and its ministries, I recognize, understand, and agree to live by the moral standards of the school. I further declare that with regard to my personal moral character and conduct, I will not engage in inappropriate conduct, including, but not limited to, such behaviors as the following: adult heterosexual activity outside of marriage commitment; homosexual or lesbian inclinations or actions; or sexual abuse or improprieties toward minors as defined by Scripture and state law; or any activity that would undermine my position as a Christian role model for children. I do declare that the above statement is factual and true. By affixing my signature, I declare that I meet the moral integrity standards and Christian role model lifestyle requirements of King’s Academy Christian School. Applicant’s Signature _________________________________________________ Date _____________________ Administrator’s Signature _____________________________________________ Date _____________________ Please sign the above in the presence of the Administrator. CRIMINAL BACKGROUND INVESTIGATION: Consent to Perform Criminal History Background Check and Advising of Rights Under the Fair Credit Reporting Act
I, ____________________________________, am an applicant for employment with King’s Academy Christian School. I have been advised that as a part of the application process, King’s Academy may conduct a criminal history background check. I, ____________________________________, do hereby consent to King’s Academy Christian School use of any information provided during the application process in performing the criminal history background check. I have been informed by King’s Academy Christian School that I have the right to review and challenge any negative information that would adversely impact King’s Academy Christian decision to offer employment. I have also been advised that King’s Academy Christian School will give me a reasonable opportunity to clear up any mistaken information reported. However, I do understand that time is of the essence and reasonableness of time is within the sole discretion of King’s Academy Christian School. King’s Academy Christian School has informed me that under the Fair Credit Reporting Act, I have certain rights concerning my review of the information reported. I will be provided the name, address, and telephone number of the reporting agency, as well as the nature and substance of all information and the source. List previous addresses not shown on application City/Town County
State
From
To
