Application for Professional Employment
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 *
Your answer
Last Name *
Your answer
Middle Initial
Your answer
Present Address
Street Address *
Your answer
City/Town *
Your answer
State *
Your answer
Zip code *
Your answer
Area Code/Phone Number *
Your answer
Permanent Address, if applicable
Street Address
Your answer
City/Town
Your answer
State
Your answer
Zip code
Your answer
Area Code/Phone Number
Your answer
Position Preference
Position Interest *
Required
Position Preference
Position Desired
Your answer
Are you a member of the NYS Teachers' Retirement System?
If yes, please provide membership number.
Your answer
Certification Area(s)
List all areas of certification and include a copy of each
New York State Certification
Certification Type, Area or Subject, Date Issued
Your answer
Educational Preparation
Include information on high school, undergraduate and any graduate work
High School
Please provide name and location
Your answer
Diploma or Degree
College (Undergraduate)
Please provide name and location
Your answer
Major
Your answer
Minor
Your answer
Diploma or Degree
Date Earned
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DD
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YYYY
College (Graduate)
Please provide name and location
Your answer
Major
Your answer
Minor
Your answer
Diploma or Degree
Date Earned
MM
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DD
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YYYY
Total Credits beyond bachelor's degree.
Your answer
Total Credits beyond master's degree.
Your answer
Presently matriculated for?
Your answer
Anticipated completion date?
MM
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Student Teaching Experience
Include dates, school district, address, cooperating teacher/principal's name, grade and/or subject.
Your answer
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 *
Your answer
Date Employment Began
MM
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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? *
Annual Salary
Your answer
Reason for leaving *
Your answer
Your Position; Name and Address of Employer; Supervisor's Name; Title; and Telephone Number
Your answer
Date Employment Began
MM
/
DD
/
YYYY
Date Employment Ended
MM
/
DD
/
YYYY
May we contact previous employer?
Annual Salary
Your answer
Reason for leaving
Your answer
Your Position; Name and Address of Employer; Supervisor's Name; Title; and Telephone Number
Your answer
Date Employment Began
MM
/
DD
/
YYYY
Date Employment Ended
MM
/
DD
/
YYYY
May we contact previous employer?
Annual Salary
Your answer
Reason for leaving
Your answer
Military Service
Please Enter Branch if Applicable
Your answer
Length of service
Your answer
Discharge other than honorable?
A dishonorable discharge will not be considered a barrier to employment
Please indicate any Co-curricular Activities (Club/Athletics) in which you participated and whether or not you would be willing to direct aforementioned activity.
Your answer
Scholastic awards or honors earned
Your answer
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.
Your answer
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.
Your answer
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 *
Your answer
Phone Number (Work/Home) *
Your answer
Name; Title; Address; Relationship to You
Your answer
Phone Number (Work/Home)
Your answer
Name; Title; Address; Relationship to You
Your answer
Phone Number (Work/Home)
Your answer
Have you ever failed to be reappointed or been denied tenure?
If you answered "Yes" to the previous question explain. (Date, location, reason)
Your answer
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)
Your answer
Are you able to perform the duties, with or without reasonable accommodations, of the position for which you are applying?
Date of Submission
MM
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DD
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YYYY
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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