APPLICATION FOR EMPLOYMENT
DATE: __________________________
NOTE TO APPLICANT: In order to help us process your application and to ensure it receives the
attention it deserves, please print clearly in ink if you are going to be mailing your application.
NAME: _________________________________________________________________________
ADDRESS: _______________________________________________________________________
CITY: _____________________________________ STATE: _________ ZIP:__________________
PHONE:________________________ EMAIL:__________________________________________
POSITION DESIRED:
_______K-3 Teacher* _______4-5 Teacher*_____Teacher Assistant ____ PreSchool Teacher ___
Middle School Teacher – Area of Preference* _______________________________________
High School Teacher – Subject Area Preference*______________________________________
Administration – Type of Position__________________________________________________
Other, please specify_______________________________________________________________
*Seeking certified teachers with a minimum of a bachelor’s degree
BACKGROUND INFORMATION
Special areas of coaching, talents, directing, interests, and ability; ________________________
______________________________________________________________________________
College activities and/or honors received before or since graduation:______________________
______________________________________________________________________________
When could you begin work? ______________________________________________________
Transcript of college work required. Please check one: ________Attached ________Being sent
Certificate (Class):_______________________________________________________________
Certification in what areas:________________________________________________________
Received from state of: ___________________________________________________________
1210 U.S. Highway 17 South · Elizabeth City, NC 27909 · (252) 338-0883 · FAX (252) 338-1222
EDUCATION
Name and Location of School
(High School, College, Graduate
Work)
Dates
Mon/Yr
Semesters
Completed
Semester
Hour
Credits
Degree or
Diploma
Major
Subject
Minor
Subject
EXPERIENCE
Name and Location
(List most recent position first)
Dates
Mon/Yr
Number of
Months
Nature of work (specify grades and subjects
taught and any extra-curricular work handled)
if applicable
Total years experience:
Have you ever failed to be re-employed to a position? _________ If yes, why? ____________________
____________________________________________________________________________________
Have you ever been arrested for any reason?_______ Explain__________________________________
____________________________________________________________________________________
REFERENCES
Please include principals and superintendents under whom you taught. Beginning teachers should
include the director of their training, campus and school. We wish permission to contact your
references listed in the placement file or in a supervisory capacity related to previous employment, in
order to complete your application. Yes ________ No________
If no, why?__________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Complete address
(Include zip code, telephone number
& email)
Occupation and Title
I certify that I have given true, accurate and complete information on this form to the best of my
knowledge. In the event confirmation is needed in connection with my work, I authorize educational
institutions, associations, registration and licensing boards, and others to furnish whatever detail is
available concerning my qualifications. I authorize investigation of all statements made in this
application and understand that false information or documentation, or a failure to disclose relevant
information may be grounds for rejection of my application, disciplinary action or dismissal if I am
employed. I further understand that dismissal upon employment shall be mandatory if fraudulent
disclosures are given to meet position qualifications.
All applicants must request a criminal background check from the Clerk of Court and present it at the
time of an interview.
Signature of applicant (unsigned applications will not be processed). Date