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BUNKER R-III SCHOOL DISTRICT P.O. BOX 365 BUNKER, (City of Oakland)

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BUNKER R-III SCHOOL DISTRICT
P.O. BOX 365 • BUNKER, MO 63629 • 573-689-2507
APPLICATION FOR CERTIFIED EMPLOYMENT
The Bunker R-III School District considers applicants for all positions without regard to race, color, religion, sex, national origin or
disability. If you have a disability or handicap which may require accommodation for you to participate in our application process
(including filling out this form, interviewing or any other pre-employment procedure or requirement), please make us aware of any
accommodation you feel is necessary. If you have any inquiries, complaints or concerns about any pre-employment procedure or
requirement, including completing this application, or about the District policy of nondiscrimination, you may contact the
Superintendent of Schools at 573-689-2507.
All applicants are expected to answer all questions on this application. Answer “none” or “not applicable” where necessary.
Date:
Name:
First
Middle
Other names that may appear on your transcripts or records:
Social Security No.:
Telephone No.:
Mailing Address:
P.O. Box/Street
City
State
Zip
Position Desired:
1st Choice
2nd Choice
3rd Choice
Areas of Certification:
Type of Certificate:
Other:
Subject:
Grade Level:
State:
Expiration Date:
Present Position:
No. of Years:
Current Salary:
EDUCATIONAL PREPARATION:
Name & Location
Dates of
Attendance
Name
of
Degree
Major
HRS
Under
Grad
HRS
Grad
Overall
GPA
High School
Colleges/
Universities
Business/
Trade Schools
Bunker R-III School District | Application for Certified Employment
TEACHING EXPERIENCE:
DISTRICT NAME & LOCATION
POSITION
DATES OF
EMPLOYMENT
NO. OF
YEARS
SUPERVISOR
PHONE
WORK EXPERIENCE:
EMPLOYER NAME & LOCATION
POSITION
DATES OF
EMPLOYMENT
NO. OF
YEARS
SUPERVISOR
PHONE
REFERENCES:
NAME
ADDRESS
PHONE
POSITION
What student activities are you willing to sponsor (e.g. Coaching, Cheerleading, Student Council)?
What collegiate honors and awards have you received?
Bunker R-III School District | Application for Certified Employment
In what collegiate activities have you participated?
In the space provided below, please provide any additional information that will help us to know you better and will tell us what you
are looking for in a teaching position.
EMPLOYMENT QUESTIONS:
1. Have you ever been arrested for, or charges with or convicted of a felony or misdemeanor?
(Exclude traffic offenses for which you were not sentenced to jail or for which the fine was less
than $100,000)
Yes
No
2. Have you ever pleaded guilty or no contest to a felony or misdemeanor? (Exclude traffic
offenses for which you were not sentenced to jail or for which the fine was less than $100.00)
Yes
No
3. Has the Missouri Division of Family Services or a similar agency in any other state or
jurisdiction, ever issued a determination of finding of cause or reason to believe or suspect
that you have engaged in physical, emotional, psychological or sexual abuse or neglect of a
child?
Yes
No
4. Have you ever failed to be re-employed by an educational institution?
Yes
No
If the answer to any of the foregoing questions is “yes” please explain. Use a separate sheet if
necessary:
Bunker R-III School District | Application for Certified Employment
READ CAREFULLY BEFORE SIGNING
I acknowledge and agree to the following provisions as conditions to consideration of my application for employment:
1. I hereby authorize my current and former employers and references to furnish any information about me and about my
work experience. I release my current and former employers and references from any and all liabilities or damages of
any nature as a result of providing such information. My current and former employers and references may rely on a
signed copy of this release.
2. I understand and consent to having criminal and arrest record checks as well as background checks by the Missouri
Division of Family Services as a condition for consideration of my application for employment.
3. I understand a check will be done through E-Verify to verify my employment eligibility and the validity of my Social
Security number.
4. I certify that the answers given in this application are true and complete to the very best of my knowledge. In the event I
am employed by the District and in the further event that I have provided false or misleading information in this
application or in subsequent employment interviews, I understand that my employment may be terminated at any time
after discovery of the false or misleading information.
5. I understand that this application will be considered active through September 1. I understand that if I wish my
candidacy to remain open after that date I must submit another application.
Signature
Date
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BUNKER R-III SCHOOL DISTRICT P.O. BOX 365 BUNKER, (City of Oakland)

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Completed 3 February 2022

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