The only way to view a PDF document on our website, you have to have a google sign in. We are trying to copy and paste all documents in manually for those of you who don't have a sign in. Applications will be harder to fill out this way due to the lines moving around. The best way to apply is to email karla.schoenfish@k12.sd.us and I will email you an application to fill out and you can scan back or mail back. SUBSTITUTE APPLICATION BON HOMME SCHOOL DISTRICT #04-2 District Office, PO Box 28, 1404 Fir Street, Tyndall, SD 57066
Name ______________________________ ______________________________ _____ Last First M.I.
Social Security Number: _____ - _____ - _____ Name as it is on Card: _____________________________________________
Substitute Position(s) for which you are applying: (Teacher, Paraprofessional, Custodian) ___________________________________
Present Address: ______________________________ City ____________________ State _________ ZIP ______________ Home Telephone (____) _______________ Cell Phone (____) _______________ Best time to call __________ Email Address ____________________________________________
Place of Employment: ______________________________________________ May we contact you at work? _____ Yes _____ No Work Telephone (____) _______________ Best time to call __________
Which school(s) would you wish to be listed as a substitute? (Check any that apply) _____ Bon Homme Hutterische Colony (K-8) _____ Dawson Colony (K-8) _____ Springfield Elementary (K-5) _____ Tabor Elementary (K-5) _____ Tyndall Elementary (PK-5) _____ Bon Homme Middle School (6-8) _____ Bon Homme High School (9-12) High School subjects for which you do NOT wish to sub: ___________________________________
Education Level (Please check one) _____ High School _____ Bachelor’s Degree (not in education) _____ Other ___________________________________ Please forward a copy of your diploma or transcript showing graduation from your highest level of education to the District Office.
_____ Bachelor’s Degree in Education Do you have a valid teaching certificate? ____yes Teaching Certificate: Number____________________ Expiration Date_______________ Do you have an expired teaching certificate? ____ yes Teaching Certificate: Number_______________ Expiration Date_______________ Please forward a copy of your teaching certificate (expired or valid) to the District Office.
Have you been convicted of a CRIME in the last 7 years? _____Yes _____No (Conviction may be relevant if job related but does not necessarily bar you from employment). If yes, please explain: ________________________________________________________ __________________________________________________________________________________________________________
Have you had a DCI/FBI background check with another school district? _____ If yes, which district(s)? _______________________________________________________________________________________
Do you have any past or current physical or mental health conditions which may affect the performance of your work? _____Yes _____No If yes, please explain: Physical Health ______________________________________________________________________________________________ Mental Health _______________________________________________________________________________________________
Are you a US citizen? _____Yes _____No If no, do you have a Green Card? _____Yes _____No
List information regarding your interests, abilities, activities, and experience which you feel has a bearing on your qualifications for this position. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
EDUCATION Name & Location From - To Degree(s) Date Received _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
EDUCATION REFERENCES Full Name Title Complete Address Telephone _________________________________________________________________________________________ _________________________________________________________________________________________
WORK EXPERIENCE Begin with most recent job. Do not include part-time or summer work unless you consider it significant. Name & Location From - To Nature of Work Supervisor _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
EMPLOYMENT REFERENCES List information for those supervisors listed above in Work Experience. Full Name Title Address, City, State, ZIP Telephone _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
Bon Homme School District is an equal opportunity employer. The Bon Homme School District does not discriminate against any employee on the basis of sex, race, religion, national origin, age, height, weight, marital status, or handicap/disability unrelated to the employee's ability to perform his/her job.
I verify that the information given by me in this application is true, accurate, and complete. I understand that if I have given any false information on this application or if I have omitted any material fact, I may be disqualified from employment with Bon Homme School District, or if hired, I may be discharged upon discovery of such false statement(s) or omission(s). I understand that my employment with Bon Homme School District may be subject to a reference/background check. I hereby authorize Bon Homme School District to investigate the truthfulness of all statements made on this application and/or contact my former employer(s) and other listed reference(s) or any other person(s) who can verify any information submitted to Bon Homme School District in support of my application for employment. I hereby waive any right that I may have against any person contact by Bon Homme School District, including former employers who provide information concerning this application and I release each said person from liability for providing information.
______________________________________________ ____________________ Signature Date |
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