South Barber Certified Application
Application For Employment, CERTIFIED
South Barber USD 255: 512 Main, Kiowa, Kansas 67070

The South Barber school district is seeking Highly Qualified teaching candidates. Minimum preparation includes a Bachelor’s Degree along with certification endorsements in each content area for which you are applying. Certification acquisition and renewal is the responsibility of the teacher/administrator.

A complete application will include: application, resume, letters of recommendation, copy of transcripts, copy of license.
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Name of Applicant *
Position Applying for *
Today's Date *
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Personal Information
Social Security Number
Date of Birth *
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Permanent Address *
Mailing Address (if different)
Home Phone
Cell Phone
Email
Contact Person (family or friend, not spouse)
Work History (Most recent, reverse chronological order)
Position 1 *
Most recent
Dates Employed
Employer/Supervisor Name
Employer/Supervisor Address and Phone
Reason for leaving
Salary/Wage
Position 2
Dates Employed
Employer/Supervisor Name
Employer/Supervisor Address and Phone
Reason for leaving
Salary/Wage
Position 3
Dates Employed
Employer/Supervisor Name
Employer/Supervisor Address and Phone
Reason for leaving
Salary/Wage
Education Background
Schools, Dates and Degrees
Please list the schools you attended, the dates you attended there, and any degrees you received.
Majors, Minors, Endorsements, and Job Skills
References
Names and addresses of those who can speak to your employability
Reference 1
Address/phone
Reference 2
Address/Phone
Reference 3
Address/Phone
Work Authorization and Availability
Are you legally able to work in the United States *
Are you currently under Contract? *
Length of contract
What school term are you available for employment?
Background
Have you ever been convicted of a violation of law other than a minor traffic violation? *
Have you ever had a professional certificate revoked or suspended? *
Have you ever been convicted of any offense for physical or sexual abuse of a child? *
Have you ever had a charge of child abuse against you substantiated? *
Have you ever been involuntarily terminated or asked to resign, or resigned in lieu of termination from the employment of another school district? *
If YES on any of the above, please explain.
Are there any reasons or limitations which prevent you from carrying out the employment duties for which you are applying?
Please list
Other Job Interests, Activities
Please list any other areas of employment in which you are interested. List any activities which you are willing to sponsor.
District Policy
The district is an equal opportunity employer and shall not discriminate in its employment practices and policies with respect to hiring, compensation, terms, condition, or privileges of employment because of an individual’s race, color, religion, sex, age, disability, or national origin. Inquiries regarding compliance may be directed to Superintendent of Schools, 512 Main, Kiowa, Kansas 67070, (620) 825-4115, or to Equal Employment Opportunity Commission, 400 State Avenue, 9th Floor, Kansas City, Kansas 66101, (913) 551-5655
Application Confirmation Statement
I affirm that all the information set forth in this application is accurate, truthful, and complete. If I am employed by the South Barber school district, I will abide by all Board of Education and school policies, carry out assigned work, an continue my professional growth to the best of my ability and within reasonable and personal standards. I grant permission for school officials to obtain a personal record check from the federal, state, county, and/or local law enforcement agencies. I release individuals listed as references from any liability for information given in response to a request for an employment reference.
I agree to the terms above (electronic signature) *
By typing your name in the box below you are signing your legally binding signature electronically.
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