BCESC Application
Please complete all questions to the best of your ability. You must submit the application at the end, if you leave before submitting your information will not be saved.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Address *
City *
State *
Zip Code *
Email Address *
Phone Number *
List Social Media sites you use *
Position applying for *
Would you be interested in being a substitute?  *
Certification *
Expiration Date *
MM
/
DD
/
YYYY
Subject Area(s) of Certificate *
Education: School(s) Attended/ Dates/ Semester Hours/ Degree/ Major (List all) *
Experience: Name of School or Employer and Location/ Dates worked/ Responsibility *
Experience 2: Name of School or Employer and Location/ Dates worked/ Responsibility
Experience 3: Name of School or Employer and Location/ Dates worked/ Responsibility
Please list your strength and other skills that would make you a strong candidate. *
Reference 1: Name/ address/ phone number/ occupation *
Reference 2: Name/ address/ phone number/ occupation *
Reference 3: Name/ address/ phone number/ occupation *
Have you ever been arrested *
Have you ever been involved in any other legal actions, including any Civil actions and/or criminal complaints that did not result in a conviction? *
If you marked "yes" on either of the above questions please explain.
Supplement to Employment Application (to be completed by all job applications) Pursuant to Sections 3319.30 and 109.57 of the Revised Code, the Board of Education of the School district does initiate an investigation by the Superintendent of the Bureau of Criminal Identification and Investigation of the State of Ohio (heareafter B.C.I. & I.) for all new employees to verify that no person has been convicted of or pleaded guilty to certain criminal offenses. Your response to the following questions is therefore required: Have you ever been convicted of or pleased guilty to any felony, or any violation of any criminal sections of the ORC, any comparable statute or ordinance of the US or any other state or municipality, any offense of violence, theft offense, any drug abuse or any sex offense? Have you ever had garnishment of wages or bankruptcy? Please state yes or now and type your name. If yes, please explain. *
Due to the length of time required for completion of the records check, it may occasionally be necessary for the Board of Education to employ a person prior to the Board of Education having received the results of the criminal records investigation. In these cases, the Board of Education shall rely on the application information provided in the employment application. However, by signing this document I specifically agree that if I am employed by the Board of Education prior to its receipt of the response from B.C.I. & I., my employment shall be contingent upon subsequent receipt by the Board of Education of a report from B.C.I. & I., and a subsequent report from B.C.I. & I. is received with is not consistent with my answer to the above question, I specifically agree that the action of the Board of Education employing me shall void without any further action by either party, and that my employment will terminate without the necessity of proceedings to formally terminate my contract of employment. Please type your full name and date, on the line below stating you have read the above carefully. *

Equal Employment Opportunity and ADA Statement

The Brown County ESC is an Equal Opportunity Employer and endeavors to provide the highest quality service through employing professionals selected for their competence and expertise. No one will be discriminated against on the basis of color, age, origin, race, gender, religion, marital status, military service or disability.


Please select today's date. By doing so and submitting you are electronically signing all the above information is accurate. *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Brown County Educational Service Center.

Does this form look suspicious? Report

Google Forms