F A I R F I E L D C H R I S T I A N A C A D E M Y
A P P L I C A T I O N F O R K - 12 T E A C H I N G S T A F F
DATE __________________________ NAME ___________________________________________________________
PHONE ________________________ EMAIL ___________________________________________________________
ADDRESS ________________________________________________________________________________________
CITY ____________________________________________ STATE _______________ ZIP CODE __________________
APPLYING FOR ____________________________________________________________________________________
E D U C A T I O N
Please begin with your most recent educaonal experience.
L I C E N S U R E
Inial licensure _____________________________________________ Year ________ State __________
Have you ever allowed your teaching license to lapse or expire? YES NO
Do you have a Professional License or a Resident Educator License?___________________________
If you are a Resident Educator, what year are you? ONE TWO THREE
List any endorsements or addional cercaons. ________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Aach a copy of your current teaching cercate to this applicaon.
INSTITUTION LOCATION DEGREE RECEIVED
E X P E R I E N C E
Have you ever been dismissed, suspended or asked to resign from a teaching posion? If yes, please explain.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Please begin with your most recent teaching experience including any student teaching experience.
List any addional experience or training as a professional educator _________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
List any other relevant professional experience __________________________________________________
_________________________________________________________________________________________
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Describe any leadership roles or responsibilies__________________________________________________
_________________________________________________________________________________________
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POSITION SCHOOL ADDRESS DATES OF EMPLOYMENT
R E F E R E N C E S
PROFESSIONAL
Name __________________________________________ Relaonship ______________________________
Phone _____________________________________ How long have they known you? ___________________
Name __________________________________________ Relaonship ______________________________
Phone _____________________________________ How long have they known you? ___________________
PERSONAL
Name _________________________________________ Relaonship _______________________________
Phone _____________________________________ How long have they known you? ___________________
Name __________________________________________ Relaonship ______________________________
Phone _____________________________________ How long have they known you? ___________________
PASTORAL
What church do you currently aend? _________________________________________________________
In few sentences briey describe your own faith journey and church involvement.
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Please ask a member of the pastoral sta at your home church to complete the aached
recommendaon form and return it to the Superintendents Oce.
Upon hire you will be asked to sign a Chrisan lifestyle commitment as well as a document that details the
mission, values and core beliefs of Faireld Chrisan Academy. Both documents are available to you on the
Employment Opportunies secon of our website, and we urge you to review them. Please sign here to
acknowledge that upon hire you will be asked to sign as an indicaon of your agreement with both of those
documents.
SIGNATURE ________________________________________________ DATE __________________________
N O N - D I S C R I M I N A T O R Y P O L I CY
Faireld Chrisan Academy does not discriminate on the basis of race, color, naonal origin, disability or
age in its privileges, programs and acvies, as it pertains to both academics and extracurricular acvies.
This non-discriminatory policy is upheld as it relates to the admiance of students as well as the hiring of
cered or non-cered personnel. As a nonpublic instuon chartered through the Ohio Department of
Educaon, FCA is not intended to be an alternave to court or administrave agency ordered, or public
school district iniated, desegregaon.
F A I R F I E L D C H R I S T I A N A C A D E M Y
1965 N COLUMBUS ST LANCASTER, OH 43130
PHONE 740.654.2889 FAX 740.654.7689
P A S T O R A L R E C O M M E N D A T I O N F O R M
Name of applicant: _________________________________________________________________________
Posion applied for: ________________________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Pastor or church sta member: please answer the following quesons to the best of your knowledge. We
appreciate your me and value your input in our decision making process. Return completed form by fax or
mail directly to the Superintendents Oce at FCA.
1. Is the applicant a member of your church? YES NO
2. How long has the applicant aended your church? ____________________________________
3. On a scale of 1 - 10, how well do you know the applicant? (1 - not at all to 10 - extremely well)
1 2 3 4 5 6 7 8 9 10
4. Is the applicant an acve and involved member of your church community? ________________________
5. How is the applicant involved in the ministry of your church? ____________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
6. Please select your level of recommendaon and explain.
Strongly recommend Recommend Recommend with reservaon Do not recommend
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
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_________________________________________________________________________________________
NAME _________________________________________ POSITION _________________________________
CHURCH _________________________________________________________________________________
EMAIL ___________________________________________________________________________________
SIGNATURE _______________________________________________ DATE __________________________
F A I R F I E L D C H R I S T I A N A C A D E M Y
1965 N COLUMBUS ST LANCASTER, OH 43130
PHONE 740.654.2889 FAX 740.654.7689