Fillable Teacher Application Editable (City of Independence, Missouri)

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Teacher Application Editable (City of Independence, Missouri)

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Matt Britt, Superintendent
Dana Beussink, Principal
LEOPOLD R-III SCHOOL DISTRICT
16797 Main Street
P.O. Box 39
Leopold, MO 63760-0039
Phone: 573-238-2211
Fax: 573-238-9868
APPLICATION FOR TEACHING POSITION
Personal
Name:
Address:
Phone Number:
Employment Desired
Position:
Date you can start:
Education
Name of School:
Years Attended:
Date Graduated:
Teaching Experience
Name and Address of School:
Grade or Subject Taught:
Dates:
REFERENCES
List three references who have first-hand knowledge of your character, personality, scholarship, and
teaching ability.
Name:
Address:
Position:
Return this application and any additional information you desire to:
Superintendent’s Office, Leopold R-III School, P.O. Box 39, Leopold, MO 63760-0039
Equal Opportunity Employer
Application will stay on file for two years
Application for Teaching Position
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 records 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 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 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.
4. I understand that this application will be considered active through April 30
th
. 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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Teacher Application Editable (City of Independence, Missouri)

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Completed 17 February 2022

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