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BONNEVILLE JOINT SCHOOL DISTRICT NO. 93 PROFESSIONAL EXPERIENCE (Bonneville Joint School District No. 93)

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BONNEVILLE JOINT SCHOOL DISTRICT NO. 93
3497 N. Ammon Rd. Idaho Falls, ID 83401 Phone: (208) 525-4400
PROFESSIONAL EXPERIENCE REPORT
B6
SECTION 1: TO BE COMPLETED BY APPLICANT
Complete the top portion of the Professional Experience Report and send to your employer(s). When this form has been
returned to you, include it in your application packet. Professional experience gained while holding a teaching certificate is the
only experience accepted.
1. Name- Last, First, Middle
1a. Maiden/Former Name
2. Address
3. Date of Birth
2a. City, State, Zip
4. Social Security Number
5. Telephone:
Business ( ) Home ( )
SECTION 2: TO BE COMPLETED BY EMPLOYER
Based on personnel records, this statement MUST be prepared and signed by the Superintendent or the Clerk of the school
district or private school where the applicant was employed. Stamped signatures MUST be initialed by the individual using the
stamp. Please return the completed form directly to the applicant.
TEACHING EXPERIENCE
FROM
TO
TOTAL MONTHS
FULL-TIME
TEACHING
ELEMENTARY
Grades Taught
SECONDARY
Grades and/or Subject Taught
SPECIAL
EDUCATION
OTHER
EXPERIENCE
School District
Signature of Superintendent or Clerk
Address (use address stamp if available)
Telephone
Title
Date
Revised: 06/13
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Completed 15 June 2021

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