Piedmont Classical High School Substitute Application
Please complete this application in its entirety and submit.You can upload your resume at the bottom.

4100 Yanceyville St., Brown Summit, NC 27214
Phone: 336-897-1128
Email: office@piedmontclassical.com
www.piedmontclassical.com
School Hours: 8: 00 AM - 4:00 PM

If you have any questions, please Angela Jackson, Director of Operations, at: ajackson@piedmontclassical.com

Email address *
Re-enter email address *
First Name *
Middle Name
Last Name *
Social Security Number *
Birth Date *
MM
/
DD
/
YYYY
Driver's License Number/State *
Home Address (Street Address, City, State, Zipcode) *
Mailing Address (if different than Home address)
County of Residence *
Cell Phone Number *
Education (check all that apply) *
Required
Teaching License (if you have teaching license, please indicate the area of licensure and the State
1.Days you are available to Work *
Required
2. Have you ever been convicted, pled guilty or pled no contest to any criminal offense other than a minor traffic violation? If yes, provide explanation. *
Question #2 Explanation
3. Have you ever had a professional certificate, credential or license of any kind revoked or suspended? If yes, provide explanation. *
Question #3 Explanation
4. Reference: Name, Position, email, phone
Upload Your Resume and Teaching Certificate (if you have one) *
Required
I affirm that all answers are accurate and true *
Submit
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