Unified School District #333
Certified Application Form
Equal Opportunity Employer

The information provided herein will become part of the employee's personnel record if employed by this district. It is only one component of a prospective applicant's file for employment.

Current credentials, transcripts, résumé, and a copy of appropriate certification must be sent in addition to this application to be considered for any vacancy in U.S.D. #333, Concordia. The applicant's résumé must include; 1) educational background; 2) any teaching or school related work experiences; and 3) at least four educational references. Candidates may be asked to provide a videotape of their teaching or student teaching, which would become the property of U.S.D. #333.

Check appropriate blanks:
Candidate for: Level:
Teacher Elementary
Counselor Middle School
Substitute Teacher Secondary
Other (Specify)

Personal Data

Date of Application Social Security Number
                                                                                                           Optional Unless Hired

Name

Present Address
Street City State Zip

At this address until (date) Phone

Permanent Address
Street City State Zip

Phone     Email Address 


Position(s) applied for in order of preference:

Position

Years of Experience in similar positions

  Professional Data

Are you presently under contract with any school district? Yes No

If so, when does your contractual obligation expire?

  CERTIFICATION: (Omit this area if a photocopy of your certificate will be provided.)
Do you hold a Kansas Certificate? Yes No Expiration Date
If not Kansas, please list state.

Endorsement Code

Level

Field/Subject

As part of requirements for certification, were you required to take the national Teacher Exam?

Yes No

If yes, date passed

PERSONAL REFERENCES (required)

Name & Title

Phone

Address

List activities you are qualified for and willing to supervise or coach in addition to your teaching duties:
 

Describe yourself, emphasizing those personal qualities which characterize your work in your present position. This will also apply if you are a student.
 

"Our greatest contribution is to be sure there is a teacher in every classroom who cares that every student, everyday, learns, grows and feels like a real human being." Briefly describe how you will accomplish these goals as a classroom teacher.

Affidavit of Continuous Residency
State of Kansas                  )
County of   )
By submitting this on-line application, I certify that the following information is true and complete.
1.  I have been a permanent resident of the State of Kansas for the past  year(s).
2.  I have resided at the following addresses for the last 10 years: (List most recent first.)
Address (Street, City, Zip)                                                     From                           To
    
    
    
    
    
    
    
    
 
In addition to completing this online application the candidate needs to mail a formal letter of application, resume, credentials and transcripts to
USD #333, 217 West 7th, Attention: Mr. Karl Stricker, Concordia. Ks. 66901.

Questions and inquiries may be emailed to Mr. Stricker at kstricker@usd333.com.

Have you been interviewed previously by USD 333?         Yes             No
Approximate date of that interview: