Tempe School District No South Rural Road P. O. Box Tempe, Arizona Phone: (480)

Transcription

1 Tempe School District No South Rural Road P. O. Box Tempe, Arizona Phone: (480) CLASSIFIED PERSONNEL APPLICATION Tempe School District No. 3 is an Equal Opportunity Employer, complies with Title IX, and has an Affirmative Action Program. Please Print Clearly. Answer all questions completely. This application is part of the examination procedure. Incomplete information will affect your evaluation. No question on this application should be answered in such a manner as to disclose race, color, religion, national origin, ancestry, age, marital status, sex or the existence of any physical or mental condition unrelated to the performance of the position for which you are applying. Date: Telephone: H: ( ) C: ( ) Name: Present Address: Permanent Address: Last First Middle Street City State Zip Code Street City State Zip Code Other Names used on other employment or educational records: Emergency Contact: (Must Be Completed) Name Address Telephone number EMPLOYMENT DESIRED 1. POSITION(S) DESIRED: (Indicate one or more) Full-time Part-time Temporary/Substitute a. b. c. When will you be available? 2. Do you have a driver s license? Yes No License Number Issuing State 3. Do you have a Commercial Driver s License? Yes No What Class? APPLICATIONS MUST INCLUDE TWO (2) LETTERS OF REFERENCE. (Applications WILL NOT be accepted without reference letters. These should be from persons other than relatives.) Submission of a resume recommended, not required. INSTRUCTIONAL ASSISTANT POSITIONS: The No Child Left Behind (NCLB) Act requires: 60 credit hours, AA degree or a passing score on the ParaPro or WorkKeys assessment test. A copy of your transcripts must accompany your application. (Official transcripts are required at time of employment.) CLERICAL POSITIONS: A written skills test may be required (a calculator may be brought to the test). A word processing test is REQUIRED. A minimum of 40 w.p.m. is required except for positions that state a higher speed. Testing sessions are held on Monday of each week at 2:00 p.m. at the District Office. Allow 1 to 2 hours for testing. BUS DRIVER: The law requires bus drivers to be at least 21 years of age. HUMAN RESOURCES DEPARTMENT Job Line Telephone: (480) Fax Telephone: (480) Classified: (480) Please visit our website at Revised 8/12 1

2 EMPLOYMENT HISTORY 1. Please list your entire employment history, with the most recent experience first. Attach additional pages or a resume if additional space is needed. In order to be considered, all phone numbers and addresses must be current and accurate. DATES EMPLOYED EMPLOYER S NAME (include address) PHONE SUPERVISOR S NAME REASON FOR LEAVING POSITION TITLE 2. Are you a former TD3 employee? Yes No Dates of employment 3. Please explain any gaps in employment 4. List schools attended and special training received: EDUCATION Circle highest year completed High School College High School Name Location (City & State) Dates Attended Year Graduated Diploma/ Degree GED None College Technical School Indicate college hours completed or degree awarded 5. Describe additional training not listed above (i.e., trade school, business school, etc.) Revised 8/12 2

3 Please type or print. PERSONAL INFORMATION 6. Name: Date: 7. What languages do you speak? Read? Write? 8. List two (2) reasons why you are applying for this position. a. b. 9. List one (1) strength or asset that you feel you have that would benefit Tempe School District No. 3. a. 10. List any relatives now employed by Tempe School District No. 3. NAME RELATIONSHIP DEPARTMENT OR SCHOOL 11. Are you currently receiving benefits from the Arizona State Retirement System? Yes No PRIOR ADVERSE PERSONNEL ACTIONS Because of the tremendous responsibility the District has to its students and the community, all applicants are required to provide answers to the following questions. Questions regarding this portion of the application should be directed to the Director of Human Resources. Use additional paper if necessary to completely and accurately answer these questions and provide any other information you believe might be relevant. An answer of yes to any of the questions below will not necessarily be a bar to employment. However, the District may refuse to hire applicants and may discharge employees who have falsified answers to the questions or who fail to accurately and completely answer such questions. If any of the questions are marked yes, attach a letter of explanation. 12. Have you ever been dismissed from a position?.. Yes No 13. Have you ever been asked to resign from a position?... Yes No 14. Have you ever resigned rather than face disciplinary action and/or non-renewal by an employer and/or disciplinary action against a license/certificate?... Yes No 15. Have you ever been disciplined for any reason which resulted in suspension from work (with or without pay)? Yes No PERSONAL REFERENCES 16. Give names and complete addresses of two or three references who are familiar with your personality, character and work habits. (Do not use relatives as references.) NAME/ADDRESS YEARS KNOWN OFFICIAL POSITION WORK PHONE HOME PHONE Revised 8/12 3

4 CRIMINAL ACTIVITY REPORT Because of the tremendous responsibility Tempe School District No. 3 has to its school children and community, the following information is required from all applicants and employees. A record of arrest conviction* does not prohibit employment; however, failure to complete this form accurately and completely may mean disqualification from consideration, or may be cause for dismissal, if employed. Failure to disclose all information may result in prosecution for filing false information with a public agency. Applicants and employees must report any convictions and arrests that occur subsequent to the time they initially completed this form. All applicants who are offered employment will be fingerprinted at time of hire. 1. Name: Last First Middle Former Name(s): Answer these questions truthfully even if the condition was ultimately expunged, reversed or otherwise set aside. If any of the questions are answered YES, ATTACH A LETTER OF EXPLANATION. 2. Have you ever been convicted* of a misdemeanor offense(s) other than traffic violation(s)?... Yes No 3. Have you even been convicted* of a DUI offense?... Yes No 4. Have you ever been convicted* of a felony?... Yes No 5. Have you ever been convicted* of a sex or drug related offense?... Yes No 6. Have you ever been convicted* of a dangerous crime against children as defined in A.R.S ?** Yes No 7. Have you ever been arrested for any offense which has not yet been resolved?... Yes No * CONVICTION is defined as any time you were found guilty of an offense and: - forfeited a bond; - received a suspended sentence; - received a deferred sentence; - served a term of probation; - conviction was expunged or set aside; - served time in prison; and/or - paid a fine; - served time in a city or county jail; - plea of nolo contendere ** A.R.S requires applicants to give notice of any conviction for dangerous crimes against children. These crimes are defined in A.R.S If you are uncertain as to whether any conviction is for a dangerous crime against children it is your responsibility to review this law. Under penalty of criminal prosecution and dismissal, I hereby certify that the information presented in this application is true, accurate and complete. I understand and agree that misrepresentation or omission of relevant facts would be good cause for rejection of my application or, if I have been employed, for immediate termination of my employment. I understand that, if I am considered for an offer of employment, Tempe School District No. 3 will conduct a background investigation for the District to determine my eligibility, qualifications and suitability for employment. I hereby give my consent for any employer or educational institution to release any information requested for this background investigation. Also, I waive any right I have under state or federal law to review or obtain a copy of such information. I understand that my employment is not finalized until the background investigation has been completed and the Governing Board has officially approved my employment. I release, hold harmless and agree not to sue or file any claim of any kind against any current or former employer or educational institution, and any officer or employee of either, that in good faith furnishes written or oral references requested by the District to complete its background investigation. A photocopy or facsimile copy of this form that shows my signature shall be valid as an original. Furthermore, I understand that I have no right or access to any materials submitted and information gathered by the District during the application process and that such materials and information are considered the sole property of Tempe School District No. 3. Signature Date Revised 8/12 4

5 Dear Applicant, Thank you for your interest in a classified position with Tempe School District No. 3, home of small, safe, neighborhood schools, highly qualified staff and exceptional students! Our schools have been recognized for excellence numerous times at the state and national level many times. We are currently recruiting quality support staff to add to our outstanding educators. The most current job openings are posted at our District Office, the District Website ( and on the Job Line ( ). If you are applying for a position that is not currently posted we encourage you to continuing checking our website or job line for available job openings and contact the District Office at to express interest. You will find that our District strives to provide for its students the very best in academic, social, physical, and emotional development. This can only occur through the efforts of the excellent staff here at Tempe School District No. 3. If there are any questions we can answer regarding our district or the application process, we would be most happy to do so. We look forward to receiving your completed application. Sincerely, Laura Hauer Executive Director of Human Resources

6 GENERAL INFORMATION Please read and fill out your application completely, (please do not indicate see resume. ) Provide all information requested and account for all time and experience. Attach a separate sheet of paper for continuation if necessary. Your qualifications will be evaluated on the basis of information provided on this application so please provide us with the most detailed information possible. ALL APPLICANTS MUST: 1. Complete fully and sign a Classified Personnel Application. 2. Provide current telephone numbers for prior employment verification. 3. Provide a copy of your resume (suggested, but not required) 4. Provide two (2) letters of reference. Letters should be from recent employers and within the last 3 years. Applications will not be accepted without signed reference letters. Do not use relatives as references. 5. Be a high school graduate or have a GED. INSTRUCTIONAL ASSISTANT APPLICANTS: The No Child Left Behind (NCLB) Act requires: 60 credit hours, AA degree or a passing score on the ParaPro or WorkKeys assessment test. Submit copies of transcripts from all colleges and universities you have attended or passing scores on the ParaPro or WorkKeys assessment test. Official transcripts are required at time of employment. CLERICAL POSITIONS: 1. A written skills test may be required. 2. A calculator may be brought to the test. 3. A word processing test is required and should be updated annually. 4. A minimum of 40 w.p.m. is required except for positions that state a higher speed. Testing sessions are held on Monday of each week at 2:00 p.m. at the District Office. Allow 1 to 2 hours for testing (if skills test is needed). Appointments are not necessary. FINGERPRINTS/BACKGROUND CHECK: Upon conditional date of hire, all classified employees must be fingerprinted. Fingerprint checks will be made by the Arizona Department of Public Safety and the Federal Bureau of Investigation. Upon conditional hire, all classified employees must pay the cost of fingerprinting to Tempe School District No. 3. All employment with Tempe School District No. 3 is conditional until the Governing Board approves such employment and until the background checks, including those involving mandatory fingerprinting, have proved to be satisfactory in the sole discretion of the District. Tempe School District No. 3. reserves the right to contact all agencies and individuals who have information on the applicant. Upon conditional hire, all classified employees must certify, before a notary public, on a written form to be provided by the District that they are not awaiting trial and have never been convicted of or admitted committing criminal offenses as specified in Certification in Accordance with A.R.S D. IMMUNIZATION: It shall be a condition of employment that the employee provide the district with proof of immunization for Rubella or Rubeola, Tuberculosis (TB) and Tetanus Diphtheria (Td). Additional immunization may be required for staff working in preschools and licensed daycare programs. PRESCHOOL OR LICENSED DAYCARE PROGRAMS: Classified employees, whether full-time, part-time, substitutes or volunteer, are required to submit the following: 1. Documentary evidence of Tuberculosis (TB) Skin Test (Mantoux) and Tetanus Diphtheria (Td) Immunization 2. A copy of the Applicant Fingerprint Clearance Card Application, copy of a Class I or II Clearance Card and the original Criminal History Affidavit. 3. Copy of current CPR and First Aid card for employment file. APPLICATION RENEWAL Applications will remain active for two (2) years. Candidates should contact Human Resources if they wish to keep their file active. Applicants and employees must maintain a current up-to-date file. You can stop by the reception desk or call (480) to request an updated application. Revised 9/11