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Application Short Form: Please Complete Two Pages and Attach Resume

This document is an application for various positions at the Pathways Schools Administrative Office. It requests contact information, background details, education and certification information, employment history, and references from applicants. Applicants are asked to check the position they are interested in, provide their availability, and how they heard of the openings. They must confirm their eligibility to work in the US and ability to perform the job. The application collects information on the applicant's resume, education, professional licenses, and last two employers' contact details. It requests three additional references that can speak to the applicant's qualifications.

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Sooks Smith
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46 views

Application Short Form: Please Complete Two Pages and Attach Resume

This document is an application for various positions at the Pathways Schools Administrative Office. It requests contact information, background details, education and certification information, employment history, and references from applicants. Applicants are asked to check the position they are interested in, provide their availability, and how they heard of the openings. They must confirm their eligibility to work in the US and ability to perform the job. The application collects information on the applicant's resume, education, professional licenses, and last two employers' contact details. It requests three additional references that can speak to the applicant's qualifications.

Uploaded by

Sooks Smith
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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The Pathways Schools Administrative Office

1106 University Blvd. West


Silver Spring, MD 20902

APPLICATION SHORT FORM


Please complete two pages and attach resume
Job Interest

Check position desired: Date available to begin working __________


Teacher (Certification required) Substitute Teacher
Teaching Para-professional Crisis Intervention Specialist
Therapist (License required)

How did you learn of positions at Pathways?


Newspaper advertisement Interne t
Personal referral from ______________________________________ (name)
Other _____________________________________________________________

Contact information

Name Social Security No.


Last First Middle
Address
Street City State Zip
Telephone Home (_____) ____________________ Cell _________________
Email:
May we contact you at work? Yes No

If yes Work (____) __________________ Best time to call you at work ___________________

Personal Background

Are you legally eligible for employment in the United States? Yes No

If no, please explain __________________________________________________________________________________


______________________________________________________________________________________________________

If you are disabled, can you do job without accommodations? Yes No

If no, please explain __________________________________________________________________________________

Have you ever been convicted of a crime? Yes No

If yes, please explain _________________________________________________________________________________

______________________________________________________________________________________________________

Education and Certification

Completed High School Attended college


Completed College (Bachelor’s Degree) Completed graduate school (Master’s or above)

List professional certificates and licenses (TEACHING, SOCIAL WORK, COUNSELING, ETC.)

ISSUING STATE TYPE OF CERTIFICATION VALID DATES (FROM – TO) AREAS CERTIFIED TO TEACH

_______________________________________________ _______________________________________________________________

________________ ____________________________ ___________________________ __________________________________

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Employment History
If you were employed under a different name, please include that name. _________________________________

List your last two employers:

Employer _______________________________________________________________ Telephone (______) ________________________

Address ___________________________________________________________________________________________________________

Job Title ___________________________________________________________ Dates employed _____________to _______________

Reason for leaving _________________________________________________________________________________________________

Last salary _________________________

Immediate supervisor and title _____________________________________________________________________________________

May we contact for reference? Yes No

Summarize nature of work performed and job responsibilities _______________________________________________________

____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

Employer _______________________________________________________________ Telephone (______) ________________________

Address ___________________________________________________________________________________________________________

Job Title ___________________________________________________________ Dates employed _____________to _______________

Reason for leaving _________________________________________________________________________________________________

Last salary _________________________

Immediate supervisor and title _____________________________________________________________________________________

May we contact for reference? Yes No

Summarize nature of work performed and job responsibilities _______________________________________________________

____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

References
List name and current telephone number of three (3) additional work references who are not related to
you and who know your qualifications and fitness for the kind of job for which you are applying. Do not
include immediate supervisor already listed above. For recent graduates with limited employment
experience, school references are acceptable.

Name _____________________________________________________________________ Years known ________________

Telephone (_______) _____________________ Reason for knowing __________________________________________

Name _____________________________________________________________________ Years known ________________

Telephone (_______) _____________________ Reason for knowing __________________________________________

Name _____________________________________________________________________ Years known ________________

Telephone (_______) _____________________ Reason for knowing __________________________________________

Signature of applicant _______________________________________ Date __________

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