Application for Professional Employment
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Email *
Date of Application *
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Required Document Copies

For a complete application, be sure to include:

Copy of transcripts of all colleges attended, credential file or three letters of recommendation (from supervisors/employers), copy of certification(s) and fingerprint clearance.

Document copies should be returned to:

Superintendent of Schools
Southern Cayuga Central School District
2384 Route 34B
Aurora, NY 13026

Are your fingerprints on file with the NYS Education Department? *
Personal Information
First Name *
Last Name *
Middle Initial
Present Address
Street Address *
City/Town *
State *
Zip code *
Area Code/Phone Number *
Permanent Address, if applicable
Street Address
City/Town
State
Zip code
Area Code/Phone Number
Position Preference
Position Interest *
Required
Position Preference
Position Desired
Are you a member of the NYS Teachers' Retirement System?
Clear selection
If yes, please provide membership number.
Certification Area(s)
List all areas of certification and include a copy of each
New York State Certification
Clear selection
Certification Type, Area or Subject, Date Issued
Educational Preparation
Include information on high school, undergraduate and any graduate work
High School
Please provide name and location
Diploma or Degree
Clear selection
College (Undergraduate)
Please provide name and location
Major
Minor
Diploma or Degree
Clear selection
Date Earned
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College (Graduate)
Please provide name and location
Major
Minor
Diploma or Degree
Clear selection
Date Earned
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Total Credits beyond bachelor's degree.
Total Credits beyond master's degree.
Presently matriculated for?
Anticipated completion date?
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Student Teaching Experience
Include dates, school district, address, cooperating teacher/principal's name, grade and/or subject.
Employment Experience
Please list all experience in reverse chronological order; include business, trade or summer occupations.
Your Position; Name and Address of Recent Employer; Supervisor's Name; Title; and Telephone Number *
Date Employment Began *
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DD
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YYYY
Date Employment Ended *
MM
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May we contact previous employer? *
Annual Salary
Reason for leaving *
Your Position; Name and Address of Employer; Supervisor's Name; Title; and Telephone Number
Date Employment Began
MM
/
DD
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YYYY
Date Employment Ended
MM
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DD
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YYYY
May we contact previous employer?
Clear selection
Annual Salary
Reason for leaving
Your Position; Name and Address of Employer; Supervisor's Name; Title; and Telephone Number
Date Employment Began
MM
/
DD
/
YYYY
Date Employment Ended
MM
/
DD
/
YYYY
May we contact previous employer?
Clear selection
Annual Salary
Reason for leaving
Military Service
Please Enter Branch if Applicable
Length of service
Discharge other than honorable?
A dishonorable discharge will not be considered a barrier to employment
Clear selection
Please indicate any Co-curricular Activities (Club/Athletics) in which you participated and whether or not you would be willing to direct aforementioned activity.
Scholastic awards or honors earned
Other Experience: *
List participation in any professional activity or committees and your experience in the following or related areas: curriculum development, teaching material selection, school/community relationships, student learning, educational travel, lectures, addresses, publications, organizational membership, committee chairs or memberships, participation in educational experiments, innovations, special programs, elective positions held, community and social services, scouting and recreation that you would consider relevant to your ability to perform the duties of this position.
Candidate's Statement *
We seek candidates for professional positions who can express themselves in a clear, mature concise and grammatically correct manner. Please submit a statement regarding your focus or motivation toward this position which reflects your beliefs about student learning and your reflection upon specific contributions you can make to the Southern Cayuga Central School community as an educator.
Employer References
List names of those who have closely observed your work as an educator. Be sure to include present or former supervisors.
Name; Title; Address; Relationship to You *
Phone Number (Work/Home) *
Name; Title; Address; Relationship to You
Phone Number (Work/Home)
Name; Title; Address; Relationship to You
Phone Number (Work/Home)
Have you ever failed to be reappointed or been denied tenure?
Clear selection
If you answered "Yes" to the previous question explain. (Date, location, reason)
Have you ever been convicted of a felony or misdemeanor? *
If you answered "Yes" to the previous question please explain. (Date, location, nature of act)
Are you able to perform the duties, with or without reasonable accommodations, of the position for which you are applying?
Clear selection
Date of Submission
MM
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Non-Discrimination Policy
The Southern Cayuga Central School District does not discriminate on the basis of race, color, national origin, religion, sex, disability or age in its programs and activities. The following persons have been designated to handle inquiries regarding the non-discrimination policies and grievances: Business Administrator for employees; and School Psychologist for students.
Acknowledgment
By submitting the online application, I hereby certify that the information presented in this employment application is true, accurate and complete. I further acknowledge that any falsification or omission will be sufficient cause for disqualification or dismissal if employed, regardless of when discovered. References and personal information which become part of this record are to be regarded as confidential and I waive my right of access to any information submitted by these references. By submitting the information herein, I hereby authorize the Southern Cayuga Central School District to verify any and all information contained herein by any means possible.
If you knowingly make a false statement in this application, you commit a misdemeanor.
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