APPLICATION FOR PROFESSIONAL STAFF
OXFORD CITY SCHOOL SYSTEM
Position Applied For (check one or more)
Early Childhood Teacher Administration
Elementary Teacher Guidance
Secondary Teacher Media Specialist
List specific subject area
Special Education Teacher (Check Grade Level)
_________________________________
K- 6
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7-12
Statement of Policy: The Oxford Board of Education is an equal opportunity employer. It is the policy of the Oxford City Board of
Education that no person shall, on the grounds of race, color, disability, sex, religion, creed, national origin or age, be excluded from
participation in, be denied the benefits of, or be subjected to discrimination under any program, activity or employment. The Oxford City
Board of Education provides equal access to the Boy Scouts and other designated youth groups.
______________________________________ __________________________________________ _____________________
Name (as shown on your Social Security Card) Name on college/employment records if different Social Security Number
Date of Application___________________________________ Date available for employment_____________________________
Present Address______________________________________________________________________________________________
Street City State Zip
Telephone Number _______________________________ Email ___________________________________________
Permanent Address ___________________________________________________________________________________________
(If different from Street City State Zip
address above)
Have you ever been convicted of a crime? Yes No If Yes, please explain:
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Note: A conviction record will not necessarily be a bar to employment. Age and time of the offense, as well as the seriousness
and nature of the violation, will be taken into consideration.
ALABAMA TEACHER’S CERTIFICATE
Teacher Number_______________ Expiration Date______________ Teaching fields on certificate__________________________
PROFESSIONAL CERTIFICATION
State Rank Certification Grade Levels Date Issued Valid Periods
_______________ __________ ___________________________ ________________ ___________________ _______________________
_______________ ___________ ___________________________ ________________ ___________________ ______________________
_____________ __________ ________________________ ______________ ________________ ____________________
EDUCATIONAL AND PROFESSIONAL TRAINING (Begin with most recent.)
School and Location Dates Attended Major Minor Diploma/Degree
_________________________________________ _________________________ _________________ ___________________ _______________________
_________________________________________ _________________________ __________________ ___________________ _______________________
_
_________________________________________ _________________________ _________________ ___________________ _______________________
EDUCATION EMPLOYMENT RECORD (List professional educational experiences, classroom and administrative, beginning with the most
recent. A resume will not substitute for this information.) If a teaching position is unavailable would you consider an aide’s position? Y N
Dates Grade/Subject or Position Taught Name and Address of Employer Years Taught
___________ _______________________________ ___________________________________________ _______________
______________ ______________________________________ ______________________________________________________ ___________________
______________ ______________________________________ ______________________________________________________ ____________________
