STPCS Application for Employment

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Saint Patrick Catholic School Application for Employment

Please fill out as completely as possible. Items marked with an asterisk (*) are required

Personal Information

*Full Name:
*Address:
*City, State:
*Zip Code:
*Cell Phone Number:
*Telephone Number:
*E-Mail address:
*Religion:
Parish
Have you previously applied for a position with Saint Patrick Catholic School?		YesNo
Earliest date available for employment:
Where did you hear about our school:

Please specify subject preferences and/or other positions not listed:

Educational Background

*Elementary School Attended:
*High School Attended:
*Date of Graduation from High School:
Extra-curricular activities in High School:
*College/University or Graduate School
*Location of College/University:
*Degrees or credits earned:
*Major/minor/field of study:
Grade Point Average:
Extra-curricular activities:
Languages Spoken:

Certification/Licensure (if not applicable, please indicate with N/A)

*Teaching Certificate Type:
*Endorsement:
*State:
*Expiration Date:
*Years of Teaching Experience
Other Certifications/Licenses or Comments:
Religion Credits:
From:

Employment Record

*Name of present or most recent employer
*Position:
*Address, City, State, Zip Code:
* Phone number:
*Dates employed:
*Name and Title of person for whom you worked:
*Annual Salary:
*Reason for leaving:
Employer previous to #1
*Position:
Address, City, State, Zip Code:
* Phone number:
*Dates Employed:
*Name and Title of person for whom you worked:
*Annual Salary:
*Reason for leaving:

Personal References

Name four persons (not relatives) more than 25 years of age, of good standing in their community, who have known you for the past five years.

*1. Name and Relationship:
*Address, City, State, Zip code:
*Phone number:
*E-Mail address:
*2. Name and Relationship:
*Address, City, State, Zip Code:
* Phone number:
*E-Mail address:
*3. Name and Relationship:
*Address, City, State, Zip code:
*Phone number:
*E-Mail address:
*4. Name and Relationship:
*Address, City, State, Zip code:
*Phone number:
*E-Mail address:

Other Qualifications

*Please summarize any objectives, abilities, and gifts you would bring to Saint Patrick Catholic School:

Also, add any additional information you feel may be helpful in considering your application. (i.e., special job-related qualifications acquired from other employment or experiences (including U.S. Military service), proficiencies (including computer skills), honors, awards, activities or professional development)

* Have you ever been convicted of a crime including sexual abuse related to children or child related offenses?

Yes
No

Criminal Records Check

By submitting this application for any school position, you hereby agree to and understand that any offer of employment shall be conditioned on receipt of a "Qualified" report resulting from the Central Criminal Records Exchange of the Virginia State Police and the FBI criminal history records required by Va. Code Ann. 19.2-389 and 22.1-296.3. In addition, a Search of the Central Registry of Child Protective Services of the Department of Social Services will be conducted. By clicking on "Submit", you consent to such a review.

By clicking on "Submit", you hereby certify (and consent to verification with appropriate individuals or organizations) that all entries made on this application and any attachments related thereto are true and complete. You understand that any falsification of information (by omission or commission) may, at any time, without notice, at the discretion of Saint Patrick Catholic School, cause termination of this application, or if already employed by the school, your employment.

Saint Patrick Catholic School does not discriminate on the basis of race, gender, color, and national or ethnic origin in the administration of our educational policies, admissions policies,employment policies, scholarships, financial aid and loan programs, athletic or other school-administered programs.