Coñazo

Application for Substituting

Position for which you are applying: ☐ Full time ☐ Part time ☐ Substitute teacher ☐ Teaching assistant ☐ Substitute teaching assistant Grade level preference: Check all that apply. ☐ Elementary school ☐ Middle school ☐ High school What days of the week are you available to work? Check all that apply. ☐ Monday ☐ Tuesday ☐ Wednesday ☐ Thursday Last name: ApplicantInformation First name:

☐ Office ☐ School-wide ☐ Friday

Middle name:

Name at birth: if different from above Have you ever been known by any other names? If so, give name and explain circumstances here. Present address: Home address: if different from above (address in your home country). Address where you have spent the most time in the past 10 years: if different from above. Presenttelephone number: including country code. Email address: Date of birth: month, day, year. Place of birth: city and country.

Citizenship: list all countries for which you hold a valid passport. Citizen national number and country of issuance: e.g. Social Security Number or Tax Identification Number. Sex ☐ Male Marital status ☐ Single

☐ Female ☐ Married ☐ Divorced ☐ Widowed ☐ Separated ☐Remarried Previous Addresses in the Past Ten Years If there is not enough space, please continue on a separate sheet. City (district/province) Country From To

Street and number

Educational institution attended including name and location

Education Major subjects

Degree awarded

Dates attended From To

Application for Substituting

Employment Please describe every position you have heldin the past ten years. Start with your present position and work back to the first position you held. Account for any periods of unemployment and state reasons for unemployment. If there is not enough space, please continue on a separate sheet. Employer including company name, Position title, responsibilities, Reason for Employment dates supervisor name, and location and accomplishments leavingFrom To

Teacher certification: if you hold a valid teacher certification, please indicate from which state or country. Special qualifications and skills: list any special skills you possess, such as word processing, driving categories, and teaching certificates.

Certification expiration date:

Approximate typing speed in words per minute:

Language

Languages Please list yourlanguages and your level of competence in each one. Speak Read Write
Excellent Good Fair Excellent Good Fair Excellent Good Fair

Understand
Excellent Good Fair

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Professional References Please list three former supervisors who have knowledge of your work performance, character, and abilities. Years as supervisor Name and position titlePhone and email address Company

☐ ☐ ☐

☐ ☐ ☐

Full name of spouse: Present address: Present occupation:

Applicant’s Spouse Date of birth: month, day, year.

Place of birth: city and country.

Citizenship: list all countries for which your spouse holds a valid passport.

Application for Substituting

Child’s full name:

Applicant’s Children Date of birth: month, day, yearChild’s grade if an AAS student or present address

Applicant’s Family Do any members of your household or any of your relatives work at AAS? ☐ Yes ☐ No If so, please list their names and positions below. Emergency Contact Full name of emergency contact: Cell phone number: Email address:

Recruitment Method How did you learn about AAS? Check all that apply. ☐ AAS faculty/staff ☐ AAS parent ☐Website ☐ Recruitment fair ☐ Word of mouth ☐ Other (please describe): Disclosures Please answer the following questions. If any of your answers is yes, please give details on a separate sheet. Yes No Have you ever been discharged or forced to resign from a position for misconduct or ☐ ☐ unsatisfactory service? If so, give details on a separate sheet. Have you now or have you ever had any physical...