Woden ISD Substitute Application

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Application for Substitute
Applicants for all positions are considered without regard to race, color, gender, national origin, age, religion, marital status, veteran or military status, the presence of a medical condition, or any other legally protected status.

First Name: *

Middle Name: *

Last Name: *

Home Phone Number:

Cell Number: *

Current Position:

Do you hold a current Texas Teaching Certificate *

Yes

Have you been a substitute at Woden ISD in past year?

Yes

Clear selection

Education History

Name of School Attended (1) *

Dates of School Attended (1) *

YYYY

Did you Receive a Diploma/Degree (1) *

Yes

Name of School Attended (2)

Dates of School Attended (2)

YYYY

Did you Receive a Diploma/Degree (2)

Yes

Clear selection

Name of School Attended (3)

Dates of School Attended (3)

YYYY

Did you Receive a Diploma/Degree (3)

Yes

Clear selection

Work Experience

List work experience chronologically with the most recent position first.

Name of Employer(1) *

Work Experience Dates(1) *

Name of Supervisor & Phone Number(1) *

Name of Employer(2) *

Work Experience Dates(2) *

Name of Supervisor & Phone Number(2) *

Name of Employer(3) *

Work Experience Dates(3)

Name of Supervisor & Phone Number(3) *

References

Give thee references

Reference 1 Name *

Reference 1 Telephone *

Reference 1 Position *

Reference 2 Name *

Reference 2 Telephone *

Reference 2 Position *

Reference 3 Name *

Reference 3 Telephone *

Reference 3 Position *

___________________

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and I understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment.

I authorize the references listed on the previous page, as well as any other reference that is not listed, to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing same to you.

I understand that the district is required by Texas Education Agency Code 21.917 to obtain criminal history record information on applicants selected for employment.

This application becomes the property of the district. The district reserves the right to accept or reject it. This application shall be considered active for one year. Any applicant wishing to be considered for employment beyond this time period may inquire as to whether or not applications are being accepted at that time.

As an applicant I authorize release of any and all information that you have concerning me, including CRIMINAL HISTORY RECORD INFORMATION and other information of a confidential or privilege nature. I hereby release you, your organization, the State of Texas and others from any liability or damage, which may result from furnishing this information:

Yes

Required

Type Name for Electronic Signature *

Date Of Signature *

YYYY

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