APPLICANT S AGREEMENT

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3 APPLICANT S AGREEMENT In exchange for your extending me the opportunity of seeking employment with the Barr-Reeve Community Schools, Inc. which I am applying, I understand and agree that: 1. Any false statements or omission of answers to questions asked on this application or in any correspondence relating thereto will be just cause for refusal of my employment, or if employed, immediate termination. 2. The Barr-Reeve Community Schools, Inc. may make any inquiry which may provide information concerning my character, general reputation, personal characteristics and past work performance, I hereby authorize and request the Barr-Reeve Community Schools, Inc. to inquire, and also authorize and request each former employer, school and person, give as a reference, and all credit bureaus, governmental and law enforcement agencies to answer all questions that may be asked and to give all information that may be sought and I hereby release them, and the Barr- Reeve Community Schools, Inc., from any liability for such statements. 3. The Barr-Reeve Community Schools, Inc. is an Equal Opportunity Employer. The Barr-Reeve Community Schools, Inc. does not discriminate in any condition of employment based upon age, race, color, religion, sex, national origin, disability, military status or other legally protected status. No questions on my employment application is used for a purpose of limiting or excluding any applicants consideration for employment on basis prohibited by local, state, or federal law. 4. All disputes, controversies or claims arising hereunder, and the interpretation of any of the provisions or the performance called for hereunder shall be governed and determined by the laws of the State of Indiana and any suit or action at law of inequity involving a dispute, controversy or claim arising hereunder shall be brought and maintained by either party in Federal or State Court located in the State of Indiana only. I hereby certify that all responses contained within this application are true and correct. Name: PRINTED SIGNATURE: DATE:

4 ADDENDUM TO EMPLOYMENT APPLICATION Request for Background Information Dear Applicant: Jobs with the Barr-Reeve School Corporation of Indiana, involve contact with our student population. We ask that you complete the questions below to help us evaluate your suitability to work with these students. All applicants for employment are expected to provide us with this information; you are not being singled out for closer inspection. The questions are part of the application itself and any misrepresentation or omission of fact may be grounds for disqualification from further consideration or for termination from employment, regardless of when the misrepresentation or omission is discovered. The conviction of a crime or any affirmative answer provided by you on this insert is not an automatic bar to employment. The School Corporation will consider the nature of any conviction or alleged conduct underlying the affirmative response, the date of the alleged conduct in question, your intervening conduct and the relationship between the offense or alleged conduct underlying the affirmative response and the position for which you are applying. 1. If you are now working, has your conduct as an employee or the quality of your work ever been the focus of any investigation by your current employer? Yes No If yes, explain the circumstances on a separate sheet and attach it to this application. 2. Have you ever resigned from a job after being disciplined by your employer or after being offered the opportunity to resign rather than be terminated? Yes No If yes, explain the circumstances on a separate sheet and attach it to this application. 3. Have you ever resigned from a prior position (with or without being asked) under circumstances involving your alleged sexual contact with another person, mishandling of funds, or criminal conduct? Yes No If yes, explain the circumstances on a separate sheet and attach it to this application. 4. Have you ever been investigated for, charged with or plead guilty or no contest to, or been convicted of any crime involving the sexual misconduct of any person, indecency with a minor, or any other crime of moral turpitude? Yes No If yes, explain the circumstances on a separate sheet and attach it to this application. (Moral turpitude is an act of baseness, vileness or depravity in the private and social duties which a person owes another member of society or society in general and which is contrary to the accepted rule of right and duty between persons, including, but not limited to theft, attempted theft, murder, rape, swindling and indecency with a minor.) Authorization and Release I authorize Barr-Reeve Community Schools, Inc. to check my employment history, including without limitation reference checks and to seek the release of investigatory information, including an expanded criminal history that might be possessed by any private or public employer or any local, state, or federal agency. I authorize these private or public employees or local, state or federal agencies to provide Barr- Reeve Community Schools, Inc. with any information they might have concerning the matters described herein, and I will cooperate to the extent necessary to obtain the release of this information. I expressly waive in connection with any request for, or provision of such information, any claims or causes of action, including without limitation, defamation, infliction of emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against the school corporation, its official, employees, trustees or agents, or against any provider of such information. I have read this authorization and release of all claims and I expressly agree to the terms set out herein. Signature Date Please Print Name

5 MEMO TO: BUS DRIVERS, COACHES, & NEW EMPLOYEES FROM: BARR-REEVE SUPERINTENDENT S OFFICE DATE: NOVEMBER 3, 2011 SUBJECT: EXPANDED CRIMINAL HISTORY POLICY/E-VERIFY/FORM I-9 Indiana State Law now requires all school corporations to obtain for each individual hired for employment that is likely to have direct, ongoing contact with children, as a result of the individual s position, to have an Expanded Criminal History check, Employer Verification (E-VERIFY and FORM 1-9 completed. Prior to beginning employment with Barr-Reeve Community Schools, Inc., you need to fill out the proper forms online so that Safe Hiring Solutions can conduct an Expanded Criminal History Check for you. As a part of that process, you will need to electronically sign a notice and authorization form consenting to this check. This authorization form will allow Safe Hiring Solutions LLC, to verify the information you provide and share its results with Barr-Reeve Community Schools. The questionnaire takes approximately 20 minutes to complete and we recommend that you double check the information you provide to ensure there is no delay with beginning your employment. The cost is $28.00 for the Expanded Criminal History check and this must be paid by the prospective employee. An associate from the Safe Hiring Solutions may contact you for additional information during the verification process. Please respond promptly so the background verification can be completed as quickly as possible so as not to delay the hiring process. If you need any assistance while filling out the application you may contact the Barr-Reeve Schools Administrative Office at or Tamara tswartzentruber@barr.k12.in.us or our background agency, Safe Hiring Solutions at or info@safehiringsolutions.com. An order summary page will confirm the information that you have submitted allowing you to review your order and make any necessary changes. Please be careful to double check all the information you provide. Once you place the order you will not be able to modify or change it. The Expanded Criminal History background check must be completed on the Barr-Reeve Community Schools website under Corporation and then employment. Click on the Safe hiring Solutions link. Please contact Tamara Swartzentruber at the central office when you have completed the request for the background check. Attached to this form is information regarding E-VERIFY and FORM I-9

6 CRIMINAL HISTORY POLICY To help ensure a safe environment and as required by state law, the Barr-Reeve School Corporation will obtain for each individual hired for employment that is likely to have direct, ongoing contact with children as a result of the individual s position an expanded criminal history check. The expanded criminal history check will be obtained by the Corporation prior to the individual s employment but no later than three (3) months after the individual s employment begins. The individual will be responsible for the cost to the School Corporation for obtaining the expanded criminal history check. Each individual hired may be questioned about the individual s expanded criminal history check. Failure to answer honestly any questions related to the expanded criminal history check may be cause for termination of the applicant. Any information obtained from any type of criminal history check is confidential and shall not be released or disseminated. All school employees and individuals or entities that have contracts for services with the Corporation are required by state law to report convictions of certain crimes enumerated in state law to the Corporation. The superintendent or designee is responsible for implementing regulations to notify the employees, including volunteers, and entities for contracted services of this duty. LEGAL REFERENCE: I.C I.C

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12 FROM: ADMINISTRATION OFFICE SUBJECT: DIRECT DEPOSIT INFORMATION DIRECT DEPOSIT WILL BE IMPLEMENTED FOR ALL EMPLOYEES. WE WILL BE NEEDING YOUR INFORMATION AS TO THE BANK YOU WANT YOUR PAY DEPOSITED INTO. ATTACH A VOIDED CHECK (DO NOT USE A DEPOSIT SLIP AS THEY ARE SOMETIMES DIFFERENT NUMBERS THAN A VOIDED CHECK) AND A SEPARATE FORM FOR EACH BANK ALONG WITH AMOUNTS AND RETURN IT TO OUR OFFICE AS SOON AS POSSIBLE. ADVANTAGES OF DIRECT DEPOSIT: -NO LOST CHECKS -MONEY USUALLY DEPOSITED BY THURSDAY AFTERNOON OR PAY WEEK -YOU MAY DESIGNATE THE BANK OR CREDIT UNION OF YOUR CHOICE -YOU DO NOT HAVE TO WAIT FOR THE MAIL DELIVERY OF 2 OR 3 DAYS AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT: BARR-REEVE COMMUNITY SCHOOLS I hereby authorize Barr-Reeve School Corp., hereinafter called Company, to initiate credit entries to my account indicated below and the depository named below, hereinafter called Depository, to credit the same to such account. NAME(S) ON ACCOUNT: ADDRESS: CITY: STATE: ZIP CODE: NAME OF BANK: TYPE OF ACCOUNT: CHECKING OR SAVINGS BANK TRANSIT/ABA ROUTING #: BANK ACCOUNT #: CHECKING: SAVINGS: AMOUNTS: WRITE FULL OR REMAINDER IF USING MORE THAN ONE ACCOUNT The authorization is to remain in full force and effect until company has received written notification from me of its termination in such time and in such manner as to afford Company and Depository a reasonable opportunity to act on it. NAME: SOCIAL SECURITY #: PRINTED NAME DATE: SIGNATURE: