School Department City of Taunton
215 Harris Street
Taunton, Massachusetts 02780
Phone: 508-821-1100 Fax: 508-821-1177
“Academic excellence for every student, in every classroom, in every school.”
1 8/2/2013
Personal Information
Name: _______________________________________________________________________________
Address: ____________________________________________________________________________________
City, State, Zip _______________________________________________________________________________
Phone:___________________ Cell Phone:_____________________ E-mail:_____________________
Date of Birth: ________________________
In case of emergency, notify: _______________________________________ Phone: ____________________
Employment DesiredȋȌ 
Position ______________________________ Date you can start?
Are you employed now? If so, may we inquire of your present employer?
Have you ever applied to this office before? Where? When?
Is this a coaching position? Yes No
School Name/s:
( high and college/s)
Location: Years Attended Date Graduated Subject Studied
Former Employers ~ (list three beginning with most recent first)
Dates of Employment Name of Employer Address Salary/Position Reason for Leaving
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Persons who would be able to provide information about your qualifications and have known you
for at least one year / NO RELATIVES
Name Address Business Home Phone Work & Cell Phone Years Acquainted
I authorize the investigation of all statements contained within this application.
Signature: ___________________________ Date: ____________________________
The Taunton Public School System does not discriminate: “No person shall be excluded from or discriminated against on the
basis of race, color, sex, religion, national origin or sexual orientation”. Such discrimination, including discrimination in
employment, is prohibited by Title IX of the Education Amendments of 1972 as amended, Section 504 of the Rehabilitation
Act of 1973 as amended, and 45 Code of Federal Regulations Parts 84 and 86. Inquiries regarding the application of these
laws should be addressed to the Assistant Superintendent or to the Director of the Office for Civil Rights, U.S. Department of
Health, Education and Welfare (Region 1), Boston, Mass. The Taunton Public School System is subject to the Age
Discrimination in Employment Act of 1967 as amended, which prohibits discrimination on the basis of age.
ŽĂĐŚĞƐKE>z: Please identify what, if any, conflicts of interest exist or may exist should you be hired as a
coach as a result of past, present, or future coaching or other experience. In none, state "none".
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