Fillable To be completed by applicant. Incomplete forms will (Millbrook Central School District)

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To be completed by applicant. Incomplete forms will not be processed.
Name of applicant: ___________________________________________________________
Date: ______________________________
Address of applicant: _______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Telephone of applicant: _______________________________________________________________________
Position: (please fill in the position being applied for)
Coaching ____________________________________________________
(requires approval signatures of A - D below)
Co-curricular ____________________________________________________
(requires approval signatures of B - D below)
Sixth Section ___________________________________
(requires approval signatures of B - D below)
Stipend Amount: _________________________________________________________________________
(as found below and in current MTA Contract)
Below to be completed by Administration
Approved by:
A. Athletic Director ___________________________________________________ Date: ________________
B. Principal ___________________________________________________
Date: _______________
C. Asst. Superintendent ___________________________________________________ Date: ________________
D. Superintendent ___________________________________________________ Date:_________________
BOE Meeting Date: ______________________________________
NOTICE TO APPLICANT: This application does not guarantee appointment and approval.
PRIOR to reporting to the above-stated co-curricular duty, all NEW employees must report to the Business Office to
complete the appropriate paperwork. In the instance of a co-curricular assignment, at the end of the season, please
submit a Claim form to your immediate supervisor in order to be paid for the position.
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To be completed by applicant. Incomplete forms will (Millbrook Central School District)

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Completed 25 July 2021

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