254

Evant Independent School District

P.O. Box 339

Evant , TX 76525

254-471-5536

Service and Support Personnel Application

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

An Equal Opportunity Employer

Personal Data:

Date of application__________________ Social Security number_______________

Name__________________________________________________________________

Last First Middle Initial

Current address_________________________________________________________

Street/Box City State Zip Code

Other address where you may be reached____________________________________

Work phone_________________________ Home phone_______________________

Email address___________________________________________________________

Other name that may appear on records_____________________________________

(Used for certification reference, and criminal history record checks.)

Position Data:

List the position(s) you are applying for: ____________________________________

____________________________________

_____Full Time _____Part-time _____Summer Only

Date you can begin work__________________________________________________

Have you been employed by Evant ISD in the past? ____Yes _____No

If you answered yes, provide dates of employment____________________________

Evant ISD Employment Application

Page 2

Education and Training:

_____Not High School Graduate: (Circle last Grade completed) _____Master’s Degree

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, ______GED

_____High School Graduate _____”Highly Qualified”

Instructional Aide

_____Two or More Years of College

_________________________________

_____Associate’s Degree

_________________________________

_____Bachelor’s Degree Describe how you met the “Highly Qualified”

Degrees Held, Certifications, License: ______________ _____Other Training or Education

_______________________________________________ ________________________________

Schools Attended

Name of School Dates Course of Degrees, Year

and location Attended Study Certification Graduated

1.____________________ ___________ ___________ ______________ ___________

___________________-

2. ___________________ ___________ ___________ ______________ ___________

___________________

3. ___________________ ___________ ___________ _______________ ___________

___________________

4. ___________________ ___________ ___________ _______________ ___________

___________________

5. ___________________ ____________ ___________ _______________ ____________

______________________

Evant ISD Employment Application

Page 3

Work Experience:

Please provide a list of all jobs you have had in the past five years. List most recent job first. Please attach a resume.

School District /Firm Position/title Dates employed Reason for leaving

1._________________ _________ _____________ ________________

2. ________________ _________ _____________ _________________

3. ________________ _________ _____________ _________________

4. ________________ _________ _____________ _________________

5. ________________ _________ _____________ _________________

6. ________________ _________ _____________ _________________

7. ________________ _________ _____________ _________________

************************************************************************

Skills

List specific skills and/or any machines or equipment you can operate. Include typing speed and number of years of experience

Evant ISD Employment Application

Page 4.

General Information:

Do you have a relative who serves on the Evant ISD Board of Education?

____Yes ____No If yes, please provide the relative’s name and relationship_____

Have you ever been convicted of, pled guilty or no contest (nolo contendre) to, or received probation, suspension, or deferred adjudication for a felony or any offense involving moral turpitude (including, but not limited to, theft, rape, murder, swindling, and/or indecency with a minor)? ____Yes ____No

If yes, please state where, when and the nature of the offense____________________

(A felony conviction 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 references on your resume or below with address and phone number, return with the completed application.

Evant ISD Employment Application

Page 5

Verification:

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understanding that any deliberate falsification, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment.

I authorize the references listed on my resume to give you 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 for any damage that may result from furnishing the same to you.

I understand that the district is authorized by the Texas Education Code 22.083 to obtain criminal history record information on applicants the district intends to employ.

_________________________________ _______________

Signature Date

This application becomes the property of the district. The district reserves the right to accept or reject it. This application shall be considered active for twelve (12) months. If you have not received a response during this time period, you may reapply or reactivate your application.

Return Application, Resume, etc. to:

Superintendent, Evant ISD, P.O. Box 339 , Evant TX 76525

For information regarding the Evant Independent School District refer to the school web site: www.centex-edu.net/evant/

Office use only

Date Application Received: _____________________ 03-07-06