MOUNTAIN VIEW CORE KNOWLEDGE SCHOOL (A CHARTER SCHOOL IN SCHOOL DISTRICT FREMONT RE-1) 890 Field Avenue Cañon City, CO 81212 www.mvcks.org Phone: 719-275-1980 Fax: 719-275-1998 Preschool Teacher Assistant Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job related medical condition or handicap. Personal Information (Please print or type) Date of Application: Last Name First Name MI Social Security Number Present Telephone Number I will be at this address until / / Permanent Telephone Number Email Position(s) Applied For: Referral Source: Advertisement Friend Relative Walk-In Employment Agency Other If employed and you are under 18, can you furnish an age certificate? Yes No Have you filed an application or been employed with MVCKS Yes No or Fremont RE-1 before? If yes, give date: Are you employed now? Yes No May we contact your present employer? Yes No Are you a U.S. citizen? Yes No Are you prevented from lawfully becoming employed in this country Yes No because of visa or immigration status? (Proof of citizenship or immigration status will be required upon employment.) On what date would you be available for work? Are you available to work? Full time Part Time Shift Work Temporary Are you on a lay-off and subject to recall? Yes No Can you travel within the district if a job requires it? Yes No Have you been convicted of a felony within the last seven years? Yes No
(Conviction will not necessarily disqualify applicant from employment.) If yes, please explain using a separate sheet of paper. Do you speak/write/read any languages other than English? Yes No List professional, trade, business or civic activities and offices held. (You may exclude those which indicate race, color, religion, sex, or national origin): Give name, address, and telephone number of three references who are not related to you and are not previous employers. Name Phone No.
EMPLOYMENT EXPERIENCE with your present or last job. Include military service assignments and volunteer activities. You may exclude organization names which indicate race, color, religion, sex, or national origin. Mountain View Core Knowledge School may contact the employers listed below unless you indicate otherwise. If you need additional space, please continue on a separate sheet of paper.
SPECIAL SKILLS AND QUALIFICATIONS Summarize special skills and qualifications acquired from employment or other experience: EDUCATION School Name Elementary High Vocational/ Trade School College/ University Years Completed (Circle) 5 6 7 8 1 2 3 4 1 2 3 4 1 2 3 4 Diploma/Degree Describe Course of Study Describe Specialized Training, Apprenticeship, Skills, and Extra-Curricular Activities In your own writing, describe your vision for an ideal environment for preschool age children. You may attach additional paper if necessary.
APPLICANT S STATEMENT I hereby authorize any person or entity whatsoever including, but not limited to, any employer, law enforcement agency, administrator, state agency, institution or private information bureau to furnish to Mountain View Core Knowledge School or any employee or agent on its behalf, any and all information or records it may have, and further to discuss with Mountain View Core Knowledge School, or any employee or agent on its behalf, any subject which may bear upon my fitness for employment with Mountain View Core Knowledge School. I specifically waive any rights or privileges I have to confidentiality of such information and release Mountain View Core Knowledge School and any person or entity providing information from all legal responsibility or liability that must result from this authorization. This authorization shall continue in full force and effect until terminated by me in writing. Further, if I should become employed by Mountain View Core Knowledge School, this authorization shall continue for the duration of such employment. A photographic copy of this authorization shall be valid as the original. I further agree that neither Mountain View Core Knowledge School nor any other person or entity shall be held liable in any respect if an employment offer is not tendered to me by Mountain View Core Knowledge School or is subsequently withdrawn or terminated for any reason whatsoever. I further understand that failure to provide any of the information requested may prevent consideration of my application for employment. I certify that the information given by me on this application and any supplement is true and correct to the best of my knowledge. I understand that false statements on this application may result in termination of employment. Signature of Applicant Date COMPLETION OF THE FOLLOWING SECTION OPTIONAL From time to time, other employers experience a shortage of candidates and will contact us for leads on applicants. If you want us to share your file with those who are seeking applicants in your area of specialization, please sign the following release. I hereby authorize sharing of my application data, including but not limited to credentials and transcripts, with other authorized employment officials who may be seeking applicants in my area of specialization. Signature of Applicant Date
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