Renick R-V School District Substitute Teacher Application

*Submit this application with a copy of your sub certificate.

The School District considers applicants for all positions without regard to race, color, religion, sex, national origin or disability. If you have a disability or handicap which may require accommodation for you to participate in our application process (including filling out this form, interviewing or any other pre-employment procedure or requirement), please make us aware of any accommodation you feel is necessary. If you have any inquiries, complaints or concerns about any pre-employment procedure or requirement, including completing this application, or about the District policy of non-discrimination, you may contact the Superintendent at 660-263-4886.

All applicants are expected to answer all questions on this application. Answer “none” or “not applicable” where necessary.

Name *

Social Security Number *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address *

List schools where you have substitute taught within the last 12 months: *

Educational Preparation:

	Name	Dates of Attendance	Degree	Major	Overall GPA
Colleges/Universities	Name	Dates of Attendance	Degree	Major	Overall GPA
Cont.	Name	Dates of Attendance	Degree	Major	Overall GPA
Cont.	Name	Dates of Attendance	Degree	Major	Overall GPA
Business/Trade Schools	Name	Dates of Attendance	Degree	Major	Overall GPA
Cont.	Name	Dates of Attendance	Degree	Major	Overall GPA

Work Experience:

	Employer Name & Location	Position	Dates of Employment	Number of Years	Supervisor	Phone
1.	Employer Name & Location	Position	Dates of Employment	Number of Years	Supervisor	Phone
2.	Employer Name & Location	Position	Dates of Employment	Number of Years	Supervisor	Phone
3.	Employer Name & Location	Position	Dates of Employment	Number of Years	Supervisor	Phone
4.	Employer Name & Location	Position	Dates of Employment	Number of Years	Supervisor	Phone
5.	Employer Name & Location	Position	Dates of Employment	Number of Years	Supervisor	Phone

Have you ever been arrested for, charged with, or convicted of a felony or misdemeanor? (Exclude traffic offenses for which you were not sentenced to jail or for which the fine was less than $100.00) *

Yes

Have you ever plead guilty or no contest to a felony or misdemeanor? (Exclude traffic offenses for which you were not sentenced to jail or for which the fine was less than $100.00) *

Yes

Has the Missouri Division of Family Services or a similar agency in any other state or jurisdiction, ever issued a determination or finding of cause or reason to believe or suspect that you have engaged in physical, emotional, psychological, or sexual abuse or neglect of a child? *

Yes

Have you ever failed to be re-employed by an educational institution? *

Yes

If the answer to any of the foregoing questions is "yes" please explain.

0/255 characters

Please upload a copy of your sub certificate. *

READ CAREFULLY BEFORE SIGNING

I acknowledge and agree to the following provisions as conditions to consideration of my application for employment:

I hereby authorize my current and former employers and references to furnish any information about me and about my work experience. I release my current and former employers and references from any and all liabilities or damages of any nature as a result of providing such information. My current and former employers and references may rely on a signed copy of this release.

I understand and consent to have criminal and arrest records checks as well as background checks by the Missouri Division of Family Services as a condition for consideration of my application for employment.

I certify that the answers given in this application are true and complete to the very best of my knowledge. In the event, I am employed by the District and in the further event that I have provided false or misleading information in this application or in subsequent employment interviews, I understand that my employment may be terminated at any time after discovery of the false or misleading information.

I understand that this application will be considered active through April 30^th. I understand that if I wish my candidacy to remain open after that date I must submit another application.

Signature: *

clear

Date: * +

NOTICE OF NONDISCRIMINATION

Applicants for admission or employment, students, parents of elementary and secondary school students, employees, sources of referral and applicants for employment, and all professional organizations that have entered into agreements with the Renick R-V School District (“School District”) are hereby notified that the School District conforms to all the laws, statutes, and regulations concerning equal employment opportunities and affirmative action. Renick R-V School District strongly encourages women, minorities, individuals with disabilities and veterans to apply to all job openings. The School District is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, or national origin, age, disability status, Genetic Information & Testing, Family & Medical Leave, protected veteran status, or any other characteristic protected by law in admission or access to, or treatment or employment in, its programs and activities. In addition, the School District provides equal access to the Boy Scouts of America and other designated youth groups. Renick R-V School District prohibits Retaliation against individuals who bring forth any complaint, orally or in writing, to the employer or the government, or against any individuals who assist or participate in the investigation of any complaint or otherwise oppose discrimination.

Any person having inquiries concerning the School District’s compliance with the laws and regulations implementing Title VI of the Civil Rights Act of 1964 (Title VI), Title IX of the Education Amendments of 1972 (Title IX), the Age Discrimination Act, Section 504 of the Rehabilitation Act of 1973 (Section 504), Title II of the Americans with Disabilities Act of 1990 (ADA) or the Boy Scouts of America Equal Access Act, is directed to the respective Compliance Coordinator listed below, who oversees the School District’s efforts to comply with the laws and regulations implementing the laws and regulations cited above.

The School District has established grievance procedures for persons unable to resolve problems arising under the statutes above. The School District’s Compliance Coordinator will provide information regarding those procedures upon request.

Any person who is unable to resolve a problem or grievance arising under any of the laws and regulations cited above may contact the Office for Civil Rights, Region VII, 8930 Ward Parkway, Suite 2037, Kansas City, Missouri 64114; telephone (816) 268-0550.

COMPLIANCE COORDINATOR

Superintendent, Renick R-V School, 101 Middle Street

Renick, MO 65278 660-263-4886

Fingerprint Background Check

All substitute teachers are required to have a fingerprint background check on file. All applicants must pre-register at the Missouri Automated Criminal History Site (MACHS) www.machs.mo.gov for a fingerprint-based background check. The background check is performed by both the Missouri State Highway Patrol (MSHP) and the Federal Bureau of Investigation (FBI). After pre-registration, all Missouri-based applicants must visit one of the IdentoGo® office locations for fingerprinting (see the “Search For Fingerprint Locations Near You” link at www.machs.mo.gov). Your required 4-digit code for Renick School substitute teacher is 1697.

If you currently substitute teach for another school district, a new background check may not be necessary. All Missouri public school districts are able to share fingerprint results with each other (based on district policy). Please note that shared fingerprint results must be less than one year old to be accepted as valid. If your fingerprint background check has been completed, please provide your date of birth and TCN number (if available). This way, Renick School District can access your previous background check report.

Renick School does not reimburse fingerprint/background check fees for substitute teachers.

TCN Number

Date of Birth * +