Scamp Teacher Application 2019
Your Name (Last, First) *
Your answer
Your email (this will be the primary method of contact) *
Your answer
Your phone number *
Your answer
Emergency contact (name and phone number) *
Your answer
Street Address *
Your answer
City *
Your answer
Zipcode *
Your answer
How many years have you worked Scamp? *
Your answer
Which group did you work with last year (if applicable)?
Your answer
Please indicate any days you may need to miss work this summer if hired. If none, write NONE. *
Your answer
All staff are provided with a shirt. Please list the size you would like to receive. *
Your answer
Please list your education, including SCHOOL, DATES, and DEGREE *
Your answer
What type of TEACHING CERTIFICATE do you currently hold, and which STATE issued? *
Your answer
What is the EXPIRATION DATE of your current teaching certificate? *
Your answer
Please list your most recent (or current) EMPLOYER, POSITION, and DATES OF EMPLOYMENT (beginning and end). *
Your answer
Please list information for any other past positions you feel are relevant to your success as an employee of Scamp (employer, position, dates)
Your answer
How would you rate your EXPERIENCE supporting challenging behavior (1 lowest to 5 highest)? *
How would you rate your COMFORT LEVEL supporting challenging behavior (1 lowest to 5 highest)? *
Please check all boxes that describe your experience and comfort supporting individuals with medical plans. *
Have Experience
Comfortable Supporting (with training)
I am not comfortable supporting these needs.
Seizures
Diabetes
Allergies/Asthma
Tube Feeding
Catheter
Please provide any additional information regarding your skills or experience that may relate to the position you are applying for at SCAMP.
Your answer
If hired, do you have any placement requests for this summer?
Your answer
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