Professional Application – Eagle Christian Academy

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Eagle Christian Academy

Application for Professional Employment

6125 Bosque Blvd. Waco, Texas 76710 (254) 772-2122
PERSONAL DATA
Full Legal Name*
First Middle Last
Maiden Name
Other name which may appear on records (Used only for reference checks):
Social Security Number*
Current Address*
Street Address City State ZIP Code
Permanent Address*
Street Address City State ZIP Code
Phone*
Email*
POSITION DATA
List the position(s) for which you are applying:*
What type of employment are you seeking?*
- Full Time
- Part Time
- Any
Date available to begin*
MM slash DD slash YYYY
Grade level preference:*
- Pre-School
- Pre-Kindergarten
- Kindergarten
- First
- Second
- Third
- Fourth
- Fifth
- Sixth
- Seventh
- Eighth
- High School

EDUCATION/TRAINING
High School Name
High School Address
Street Address City State ZIP Code
Certificate
- Diploma
- GED
College / University
Name & Address Course of study & major/minor Degree/Diploma/ Certificate/License Date Received
CERTIFICATION
Certificate or License Currently Held
- Valid Texas certificate
- Valid certificate from another state
- Alternative certification
- Completing teacher certification program
- Other
Valid Certificate from another state, please list state
Alternative certification, please list
Completing teacher certification program, Please list College/University and Month/Year to complete.
Other certificate or license, please list
Areas of Certification
- Early Childhood/Kindergarten
- Elementary
- Secondary (specify)
- All-Level Art
- All-Level Health and PE
- All-Level Music
- Special Education (specify)
- Vocational (specify)
- Librarian
- Counselor
- Mid-Management
- Other (specify)
Secondary, please list subject area
Special education, please specify
Vocational, please specify
Other, please specify

STUDENT TEACHING EXPERIENCE
List school experience beginning with most recent year.
Student Teaching School Experience
School Name/District City/State Grade Taught Supervising Teacher Name Address Phone Number
TEACHING EXPERIENCE
List school experience beginning with most recent year.
Teaching School Experience
Name & Address Type of Assignment Dates Employed, Begin - End Reason for Leaving
OTHER WORK EXPERIENCE
List all other jobs beginning with most recent.
Other Work Experience
Employer Name Position Dates Employed, Begin - End Reason for Leaving

REFERENCES
Please list references that are most familiar with your professional skills and abilities. Please provide the information of at least three reference sources. Please include: 1. A supervisor or other person who knows your professional work. 2. Current employer if now employed, or last employer if not currently employed. 3. A parent whose child you have taught.
References*
Name Position/Relationship Address Phone Number Email Address

SUBSTITUTES
If you are interest in substituting, please indicate the day(s) available.
Day(s) of the week to substitute
- Everyday
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
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 of my application or dismissal from subsequent employment.

I authorize the references listed on the previous page to provide Eagle Christian Academy any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability or any damage that may result from furnishing this information.
Signature of Applicant*
Date*

Please explain your personal philosophy of education. Please address preferred teaching methodology, the role of the teacher, discipline, the role of the parent, and any other areas that are important in your belief.*

Name & Address	Course of study & major/minor	Degree/Diploma/ Certificate/License	Date Received

School Name/District	City/State	Grade Taught	Supervising Teacher Name	Address	Phone Number

Name & Address	Type of Assignment	Dates Employed, Begin - End	Reason for Leaving

Employer Name	Position	Dates Employed, Begin - End	Reason for Leaving

Eagle Christian Academy