APPLICATION FOR SUBSTITUE POSITION
Commerce Public Schools
217 Commerce Street   Commerce, OK    74339-2200                 Telephone: (918) 675-4316
                                                                                                                Fax: (918) 675-4464

 Notice to Applicants: This school district does not intentionally discriminate in its employment policies on the basis of race, national origin, religious beliefs, age, disabilities, or gender.
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Notice of Disqualification: Failure to answer questions truthfully or providing misleading or falsified information will disqualify the applicant for any position offered by the District, and, if discovered after employment, will result in dismissal from employment.

  I state that I have read and understand this disqualification notice.   

  Applicant’s Signature:            Date:   
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A. General Information

Last Name:
First Name:
Address where you can be reached:
Phone where you can be reached:
Are you a United States citizen?  
Clear selection
If not, what documentation do you have to show that you are legally eligible to work in the United States?   
When are you available to start working?
Have you read the job description of the position for which you have applied?  
Clear selection
Are you now capable of performing the duties required of the applicant or that job?  
Clear selection
If not, how do you feel an accommodation can be reasonably made to allow you to perform essential job duties?
Have you ever worked with children?  If so, where?
Check the position(s) for which you are applying:
 Indicate below your office skills and check machines you can operate efficiently.  
Multi-lingual? If yes, what languages?
Special Education Paraprofessional Registry?
Clear selection
  Have you ever driven a bus?  
Clear selection
Number of years experience driving a bus?
CDL License?
Clear selection
  State of Oklahoma School Bus Driver’s Certificate?  
Clear selection
I UNDERSTAND I MUST OBTAIN A FOOD HANDLER’S PERMIT FROM THE DEPARTMENT OF HEALTH AND WILL BE RESPONSIBLE FOR RENEWING SAME AT THE EXPENSE OF THE EMPLOYER. (This applies to Food Service Personnel only.)

  Applicant’s Signature:          Date:   
Select Sites Your Interested in Substitute Teaching in
Days Available?
Have you previously applied for employment with this district?  
Clear selection
If yes, when was that application submitted?  
  B. Educational Background: 

Do you have a High School Diploma or a GED?  
Clear selection
  High School from which graduated:

  Graduation Date:
  College:  

  Graduation Date: 

  Degree Received:  
  Are you now or have you ever been certified to teach?  
Clear selection
 In order for a certified or formerly certified substitute teacher to be paid at the certified substitute teacher rate, a copy of the teaching certificate must be on file at the school district’s central office.
Trade or Business School: 

Name of institution: 

Attendance dates:  
Refer to the consent form at the end of this application that is needed to be signed if no transcript(s) is submitted with this application.  
  C. Employment History: 
          The District will conduct background checks to verify information provided. 



CONSENT AND RELEASE OF ALL CLAIMS AGAINST PREVIOUS EMPLOYERS 

Sign below if you agree that the District may contact your previous employers and ask them detailed questions about your prior work experience. By signing, you specifically consent to the release of information by these prior employers to the District, and agree to release such prior employers, their employees, and their governing boards, from any and all causes of action or other potential claims which you could have against them for answering questions about your work experience. This consent is a covenant not to sue any prior employer, their employees, or their board members for defamation, regardless of what said prior employers may relate to the District regarding your previous employment experience. 

I have read this consent and release of all claims, and in consideration of being considered an applicant for employment agree to its terms.  

  Applicant’s Signature:            Date:   
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  Provide the following information about your employers, with the current employer being listed first and then proceeding to your first employer. (Attach additional pages, if necessary.) 

Current Employment:
      
     A.  Employer’s Name: 
           Employer’s Address:
           Employer’s City: 
  B. Job Title/Position:  
  C. Dates of Employment:  
  D. Salary:  
  E. Supervisor(s):  
 
      Phone:   
 F. If employed under a name different from the name you are using for this application, under what name were you employed by this employer?  
  G. Reason for leaving employment:  
(Next school if applicable) 

 A.  Employer’s Name: 
       Employer’s Address:
       Employer’s City: 
  B. Job Title/Position:  
  C. Dates of Employment:  
  D. Salary:  
  E. Supervisor(s):  
 
      Phone:   
 F. If employed under a name different from the name you are using for this application, under what name were you employed by this employer?  
  G. Reason for leaving employment:  
(Next school if applicable) 

 A.  Employer’s Name: 
       Employer’s Address:
       Employer’s City: 
  B. Job Title/Position:  
  C. Dates of Employment:  
  D. Salary:  
  E. Supervisor(s):  
 
      Phone:   
 F. If employed under a name different from the name you are using for this application, under what name were you employed by this employer?  
  G. Reason for leaving employment:  
(Next school if applicable) 

 A.  Employer’s Name: 
       Employer’s Address:
       Employer’s City: 
  B. Job Title/Position:  
  C. Dates of Employment:  
  D. Salary:  
  E. Supervisor(s):  
 
      Phone:   
 F. If employed under a name different from the name you are using for this application, under what name were you employed by this employer?  
  G. Reason for desiring to leave employment:  
D. Criminal Activities: 

        The district has a duty to teach students proper citizenship and respect for the law, and employees have an obligation to serve as role models for students. Because the district teaches students about the dangers of chemical abuse and because the district is entrusted with the supervision of minors, the district cannot have employees performing duties while under the influence of dangerous substances or substances which adversely affect reaction time and good judgment. 

         Information concerning past illegal acts will be considered along with the time of the offense, the seriousness and nature of the violation, any rehabilitations and your subsequent employment history. 


Please see the attached school policies, DABB Records Investigation, DABB-P Felony Records Search Procedures, DABB-E1 Records Investigation Consent, DABB-E2 Oklahoma State Department of Education Application for Criminal History Record Search, DABB-E3 Temporary Contract Notice of Limited Employment, and DABB-E4 Authorization and Release 
Have you ever been convicted of a felony?
Clear selection
If so, provide details:  
Have you ever been convicted of a criminal offense involving illegal drugs?  
Clear selection
If so, provide details:  
Have you ever been convicted of a criminal offense involving illegal use of alcohol?  
Clear selection
If so, provide details:  
Have you ever been convicted of any criminal offense involving minors?  
Clear selection
If so, provide details:  
E. Driving Record: 

     This portion is only to be completed if you are applying for a position that requires the employee to transport students:
Has your driver license been suspended within the last 5 years?  
Clear selection
What was the reason for the suspension, and when was it reinstated?  
Have you ever been convicted of driving under the influence of drugs or alcohol?  
Clear selection
If yes, provide details:  
  F. Verification: 

       I verify the answers provided above are true and correct. I authorize investigation of all statements contained in this application. I understand misrepresentation or omission of facts called for is cause for dismissal without notice at anytime during my employment.

      I agree, if employed to follow all rules and regulations of the district. 

      I agree to promptly notify the district of any change of address or phone number during my employment.  

  Applicant’s Signature:               Date:   
 *
  CONSENT FOR RELEASE OF TRANSCRIPTS 

I, the undersigned, consent to the release of my transcripts by the following educational institutions to the Commerce School District, if a copy of the transcript is so requested by the district. 

Applicant’s Signature:             Date:  
 *
  Educational Institutions, Years of Attendance or Graduation, SSN or Student ID Number, and name on transcript, if different from name above:  
  Educational Institutions, Years of Attendance or Graduation, SSN or Student ID Number, and name on transcript, if different from name above:  
  Educational Institutions, Years of Attendance or Graduation, SSN or Student ID Number, and name on transcript, if different from name above:  
  Note: If applicable, this application will serve as your request to add your name to our lists of substitutes. Unless you notify us in writing that you are not returning or wish to be removed from our lists of substitutes, you will remain on the active substitute lists in subsequent years to be on-call as-needed. Applications for non-substitute positions must be updated annually. If not, the application will be removed from our files  
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