Fillable GRAINGER COUNTY DEPARTMENT OF EDUCATION APPLICATION FOR EMPLOYMENT

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GRAINGER COUNTY DEPARTMENT OF EDUCATION APPLICATION FOR EMPLOYMENT

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The GRAINGER COUNTY DEPARTMENT OF EDUCATION APPLICATION FOR EMPLOYMENT form is 3 pages long and contains:

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  • 6 check-boxes
  • 84 other fields

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GRAINGER COUNTY DEPARTMENT OF EDUCATION
P. O. Box 38
Rutledge, TN 37861
APPLICATION FOR EMPLOYMENT
PLEASE TYPE OR PRINT
Date of Application ____/____/____
Name________________________________________________________________________________________
Last First Middle Maiden
Current Address _______________________________________________________________________________
Street
____________________________________________________________________________________________
City State Zip Code
Date of Birth ________/________/_______ Social Security Number _______-_______-_______
E-Mail Address _________________________________ Telephone No. ______________________________
Position Desired _________________________________ Level/Subject _______________________________
If the position does not require a valid Tennessee teaching license, please skip to Educational Background portion.
Per T.C.A., any employee in a non-certified position is employed as an at-will employee.
If the position requires a valid Tennessee teaching license, please complete the following.
Date available for employment ___________________________________________________________________
EDUCATIONAL BACKGROUND
(If applicable, complete College or University transcript must accompany this application)
Name and Address of Schools
Dates: From/To
Degree/Diploma
Major
Do you hold a valid Tennessee teaching license? Yes No
(Please include a copy of your teacher license with application.)
Teaching License Number ________________________ Expiration Date ___________________________
Areas of Certification _________________________________________________________________________
Have you met the state requirements for Highly Qualified? Yes No
If so, what areas: _____________________________________________________________________
Are you presently under contract with another TN school system? Yes No
WORK EXPERIENCE IN EDUCATION
(List in chronological order, most recent first, your work history in educational settings)
Name and Address of School
Name and Address of
Principal or Immediate
Supervisor
Dates Employed
Type of Work
or
Grade/Subject
OTHER WORK EXPERIENCE
(Starting with the most recent, list the last three non-educational jobs held).
Name and Address of Employer
Name, Address and Phone
Number of Immediate
Supervisor
Dates Employed
Job
Responsibilities
REFERENCES
Name and Occupation
Address and Phone Number
How long have you
known this person
READ CAREFULLY BEFORE SIGNING
$ I certify that all information in this application is complete and correct to the best of my knowledge.
$ I agree that if any information changes either before or after employment, I will notify the Central Office
immediately.
$ I recognize that if I am employed the Board of Education may assign me to a specific position as the need
requires.
$ I have not been convicted of a misdemeanor or a felony in any state of the United States.
$ I have not been dismissed from any previous employment for improper unprofessional conduct, inefficient
service, neglect of duty, incompetence or insubordination.
$ I do not have any contagious or communicable disease which may endanger the health of school children or
other personnel.
$ I understand that misrepresentation of any statements may subject me to a fine, loss of an opportunity for
employment, and loss of position if employed.
_____________________________________________ ____________/____________/__________
Signature of Applicant Date
The following is required by Tennessee State Law and the Grainger County Board of Education:
______ I AM related to a member of the school board, the director of schools, an administrator in the system, a
county commissioner, or any appointed/elected county official.
______ I AM NOT related to a member of the school board, the director of schools, an administrator in the system,
a county commissioner, or any appointed/elected county official.
Printed Name: ___________________________Signature:__________________________Date:____/____/____
Tennessee State Law, T. C. A. 49-5-413 requires that every employee working in proximity to children must
complete a Criminal History Records Check. The check involves fingerprinting and submission of the report to
the Tennessee Bureau of Investigation. This procedure is done as a part of the employee=s intake procedure.
Employees will bear the cost of the background check. Deficient background checks will terminate employment.
The Grainger County Board of Education does not discriminate on the basis of age, sex, race, color, religion,
national origin, or disability in the operation of its educational programs and activities including employment
practices.
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GRAINGER COUNTY DEPARTMENT OF EDUCATION APPLICATION FOR EMPLOYMENT

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Completed 30 April 2021

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