Bosqueville ISD

Auxiliary Personnel Application

Bosqueville Independent School District

7636 Rock Creek Road - Waco, Texas 76708 254-757-3113 www.bosquevilleisd.org

AN EQUAL OPPORTUNITY EMPLOYER

We consider applicants for all positions without regard to race, color, national origin, age, religion, sex, marital status, veteran or military status, the presence of a medical condition, disability, or any other legally protected status.

Auxiliary Personnel Application

DATE OF APPLICATION:

DATE AVAILBLE TO BEGIN:

SOCIAL SECURITY NUMBER:

PERSONAL DATA

LAST NAME:

FIRST

MIDDLE

PRESENT ADDRESS:

OTHER ADDRESS:

WORK PHONE

HOME PHONE

CELL PHONE

EMAIL ADDRESS

POSITION DESIRED: INDICATE SCHOOL LEVELS AND SUBJECT AREAS IN WHICH YOU ARE PREPARED TO TEACH. GIVE PREFERENCE BY RANKING IN THE APPROPRIATE LEVEL OR SUBJECT AREA.

LIST THE POSITION(S) FOR WHICH YOU ARE APPLYING

FORMER BOSQUEVILLE EMPLOYEE

YES

IF YES , WHEN AND NAME AT EMPLOYEMENT

REASON FOR LEAVING

EDUCATION/TRAINING

CHECK THE HIGHEST LEVEL OF EDUCATION ATTAINED:

HIGH SCHOOL GRADUATE

NOT A HIGH SCHOOL GRADUATE

LESS THAN TWO YEARS OF COLLEGE

TWO OR MORE YEARS OF COLLEGE

FOR CLASSROOM/INSTRUCTIONAL AIDES- HAVE PASSED A RIGOROUS EXAM DEMONSTRATING MASTERY IN READING, WRITING AND MATHEMATICS

**IF NOT A HIGH SCHOOL GRADUATE PLEASE LIST THE LAST GRADE COMPLETED BELOW

Other

HIGH SCHOOL/LOCATION

CHECK APPLICABLE OPTION

DIPLOMA

GED

COLLEGE/LOCATION

DATES ATTENDED

MAJOR/MINOR FIELD

DEGREE/CERTIFICATE OR LICENSE EARNED

YEAR EARNED

WORK EXPERIENCE

LIST ANY WORK EXPERIENCE YOU HAVE HAD. START WITH YOUR PRESENT OR LAST JOB.

COMPANY/FIRM NAME

JOB TITLE

DATES EMPLOYED

REASON FOR LEAVING

ADDRESS

SUPERVISOR/PHONE

HOURLY RATE/SALARY (STARTING & FINAL)

WORK PERFORMED

COMPANY/FIRM NAME

JOB TITLE

DATES EMPLOYED

REASON FOR LEAVING

ADDRESS

SUPERVISOR/PHONE

HOURLY RATE/SALARY (STARTING & FINAL)

WORK PERFORMED

COMPANY/FIRM NAME

JOB TITLE

DATES EMPLOYED

REASON FOR LEAVING

ADDRESS

SUPERVISOR/PHONE

HOURLY RATE/SALARY (STARTING & FINAL)

WORK PERFORMED

COMPANY/FIRM NAME

JOB TITLE

DATES EMPLOYED

REASON FOR LEAVING

ADDRESS

SUPERVISOR/PHONE

HOURLY RATE/SALARY (STARTING & FINAL)

WORK PERFORMED

GENERAL INFORMATION

Do you have a relative who serves on Bosqueville ISD Board of Trustees

YES

If Yes please provide name and relationship below:

Other

Please list any languages (other than English) that you can speak, read or write fluently.

List any special/technical skills or knowledge you can contribute to our district

ALL PERSONNEL OF THE SCHOOL DISTRICT, REGARDLESS OF CLASSIFICATION, ARE EMPLOYED, SUBJECT TO ASSIGNMENT, AND/OR REASSIGNMENT BY THE SUPERINTENDENT OR BY HIS OFFICIAL DESIGNATED REPRESENTATIVE BASED UPON THE NEEDS OF THE DISTRICT. DO YOU UNDERSTAND IF EMPLOYED YOU ARE SUBJECT TO REASSIGNMENT AS NEED ARISES?

YES

HAVE YOU EVER BEEN CONVICTED OF, PLEAD GUILTY OR NOT CONTEST (NOLO CONTENDRE) TO, OR RECEIVED PROBATION, SUSPENSION, OR DEFERRED ADJUDICATION FOR A FELONY OR OFFENSE INVOLVING MORAL TURPITUDE (INCLUDING, BUT NOT LIMITED TO , THEFT, RAPE, MURDER, SWINDLING, AND INDECENCY WITH A MINOR)?

YES

IF YES, PLEASE STATE WHERE, WHEN, AND THE NATURE OF THE OFFENSE:

CONVICTION OF A FELONY IS NOT AN AUTOMATIC BAR TO EMPLOYMENT. THE DISTRICT WILL CONSIDER THE NATURE, DATE, AND RELATIONSHIP BETWEEN THE OFFENSE AND THE POSITION FOR WHICH YOU ARE APPLYING.

REFERENCES

Please list any references that are most familiar with your professional skills and abilities. Be sure to include your most recent immediate supervisor(s) (principal, superintendent, etc.). You may wish to list additional references from department heads, team leaders, curriculum specialists, professors, etc.

NAME/TITLE

ADDRESS

TELEPHONE NUMBER

NAME/TITLE

ADDRESS

TELEPHONE NUMBER

NAME/TITLE

ADDRESS

TELEPHONE NUMBER

NAME/TITLE

ADDRESS

TELEPHONE NUMBER

SUBSTITUTES

IF YOU ARE INTERESTED IN SUBSTITUTING, PLEASE INDICATE THE DAY(S) AVAILABLE AND YOUR ASSIGNMENT PREFERENCES

DAYS OF WEEK

EVERY DAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

ASSIGNMENT

ANY CAMPUS

PK-5

6-8

9-12

SPECIAL EDUCATION

PLEASE DESCRIBE WHY YOU WISHED TO BE EMPLOYED BY BOSQUEVILLE ISD.

DISPOSITION OF APPLICATION

This application becomes the property of the District. The District reserves the right to accept or reject the application. Applications will be retained and updated for a one-year period, after which the applicant must notify the Personnel Office of his.her desire to remain in an active status. It is the applicant's responsibility to advise the Personnel Office of any change of name, address, or other status while his/her application is active.

CRIMINAL HISTORY RECORD INFORMATION

The Bosqueville Independent School District is required by Texas Education Code Chapter 22 Subchapter C to review the criminal history of applicants, employees, independent contractors, student teachers, and certain volunteers. The information requested below is necessary to obtain criminal history record information.

LAST NAME

FIRST NAME

MIDDLE NAME

MAIDEN NAME

SOCIAL SECURITY NUMBER

Date of Birth

DRIVER'S LICENSE (STATE AND NUMBER)

MAILING ADDRESS (STREET, CITY, STATE AND ZIP)

SEX

MALE

FEMALE

ETHNICITY

BLACK

WHITE/OTHER

HISPANIC

AM INDIAN/ALASKAN NATIVE

ASIAN/PACIFIC ISLANDER

I understand that the information I am providing about age, sex, and ethnicity will not be used to determine eligibility for employment but will be used solely for the purpose of obtaining criminal history record information.

I understand

Signature allowing Bosqueville ISD to obtainn Criminal History Record

Date

VERIFICATION

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection on my application or dismissal from subsequent employment. I authorize the references listed on the previous page to provide Bosqueville ISD any and all information concerning my pervious employement and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing the same to the District. I understand that the District is authorized by Texas Education Code 22.083 to obtain criminal history record information on all applicants the District intends to employ.

I UNDERSTAND THAT BY SUBMITTING THIS APPLICATION THAT I AM ALLOWING BISD TO RUN ALL NECESSARY REPORTS.

AGREE

SIGNATURE OF APPLICANT

DATE

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