HPS Certified Personnel Application
MUST BE COMPLETED BY ALL PERSONS APPLYING FOR CERTIFIED EMPLOYMENT THROUGH THE HARTSHORNE PUBLIC SCHOOL SYSTEM.

Hartshorne Public Schools (I001 of Pittsburg County, Oklahoma) does not intentionally discriminate in employment policies regarding selection, transfer, promotion, termination, compensation or other benefits on the basis of race, creed, national origin, color, religion, age, physical handicaps, or sex: nor does the District discriminate in educational programs or activities.
Today's Date *
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Full Name of Applicant (First MI Last) *
The title of the position I am applying for. (MS Math/Asst Football) *
Social Security Number (555-55-5555) *
Current Address (123 Main St, Tulsa, OK 55555) *
Primary Phone Number (555-555-5555) *
Secondary Phone Number (555-555-5555)
Primary Email Address (you@email.com) *
Secondary Email Address (you2@email.com)
Have you ever been employed by the Hartshorne Public School District? *
If applicable: Position(s) held in previous employment with Hartshorne Public Schools. (MS Math/Asst. Football)
If applicable: Your name during previous employment with Hartshorne Public Schools. (First MI Last)
If applicable: What were the dates of your previous employment at Hartshorne Public Schools.
Are you at least 18 years of age? *
Are you a citizen of the United States? *
Have you ever been convicted of a crime? *
If yes, provide dates and details of criminal conduct.
Do you have experience working in a school or with large numbers of children? *
Last place of employment. (School Name/Business Name) *
Last position held. (In School or Business) *
Method of separation from last place of employment. *
Reason for separation from last place of employment. *
Provide a list of ALL current Oklahoma Teacher Certifications held. *
Please select the HIGHEST degree conferred from an accredited institution (as of the date of this application). *
Provide a list of references and phone numbers where they can be reached.
Are you presently under contract with another Oklahoma School District? *
Date you will be available to begin employment with Hartshorne Public Schools. *
Have you ever been dismissed or asked to resign from a teaching or administrative position? *
Please explain the circumstances of dismissal or agreed upon resignation.
Do you possess a valid Commercial Drivers License with School Bus Endorsement? *
Please provide a list of Military Service and/or Out-of-State teaching experience you would like considered when placing you on the appropriate step of the Hartshorne Teacher Salary Schedule.
I understand that I must complete an OSBI background check and a drug screening before any employment agreement between myself and Hartshorne Public School District will be valid. *
I understand that Hartshorne Public School District places new certified staff members on a TEMPORARY CONTRACT for the first two years. These years count toward Career Teacher status. *
I understand that Hartshorne Public Schools may contact anyone provided as a reference and information gathered from these references will be used to base employment decisions. *
I attest that the information I have provided on this application is true and accurate to the best of my knowledge. I understand that any information found to be inaccurate may require additional details before an employment decision can be made. *
The following items must be provided to the administrative office to complete the application process. (Please check ALL items you have submitted. You can provide the remaining documentation following submission of this application.) *
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