Shining Stars Montessori Academy PCS
Shining Stars Montessori Academy PCS, is an equal opportunity employer. Qualified applicants are considered without regard to race, color, religion, sex, pregnancy, age, disability, national origin, genetic information, sexual orientation, gender identity or expression, personal appearance, marital status, family responsibilities, matriculation, political affiliation, veteran status or any other basis protected by applicable federal or District of Columbia law. If needed, the school will make reasonable accommodations.
EMPLOYMENT APPLICATION
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PERSONAL INFORMATION
First Name
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Last Name
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Street Address
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City
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State
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Zip Code
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Email Address
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Home Number
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Cell Number
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Contact Preference
Date of Birth *
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What position are you applying for? *
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How did you hear about this position? *
Employment Status *
Most recent salary *
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EDUCATION
Shining Stars Montessori Academy PCS is required to verify educational credentials and provide data collection to OSSE, Department of Education, and or other authorizer entity to ensure all teaching positions meet the required guidelines.
1.Name of School *
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Level of Education *
Degree *
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Major/Subject of Study *
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2. Name of School
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Level of Education
Degree
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Major/Subject of Study
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3. Name of School
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Level of Education
Degree
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Major/Subject of Study
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PRAXIS Series
Please list your test(s) in the subject area
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Test Scores
Please list your test scores in the subject area
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Montessori Training/Certifications
Please indicate your Montessori credential accrediting institution: *
Required
Please indicate any other relevant certifications
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Please indicate which state(s) your certification(s) were obtained
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Please indicate which dates your certification(s) was obtained
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Please list your language(s) abilities
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Work Experience
Please list your last three employers
1. Employer Name *
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Address *
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Phone Number *
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Supervisor/Title *
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Position *
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Job Duties *
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Date From *
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Date To *
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Final Salary *
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Reason for Leaving *
Explanation *
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2. Employer Name
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Address
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Phone Number
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Supervisor/Title
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Position
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Job Duties
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Date From
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Date To
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Final Salary
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Reason for Leaving
Explanation
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3. Employer Name
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Address
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Phone Number
Your answer
Supervisor/Title
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Position
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Job Duties
Your answer
Date From
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Date To
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Final Salary
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Reason for Leaving
Explanation
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References
Please list three professional references
1. Name
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Company Name
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Phone Number
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Email
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Position
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2. Name
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Company Name
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Phone Number
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Email
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Position
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3. Name
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Company Name
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Phone Number
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Email
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Position
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Voluntary Self-Identification
Shining Stars Montessori Academy PCS is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, the school is required to invite applicants to voluntarily self-identify their gender and race/ethnicity.

Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. If you do not wish to provide this information, you can indicate as such in your answers.

The information will be kept confidential and may only be used in accordance with the provisions of applicable laws and regulations, including those, which require the information to be summarized and reported.
1. Gender (Select one)
2.Race/Ethnicity
Signature, Date, and Certification of Accuracy
Please read carefully before submitting.

Accurate Information: I hereby certify that all information provided herein is true and correct and I have not knowingly withheld any information that might adversely affect my chances for employment. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any misrepresentation or deliberate omission here may preclude any offer of employment, or may result in a withdrawal of an employment offer, or may result in discharge from employment if I am already employed at the time the misrepresentation or omission is discovered, regardless of the time lapsed before discovery. I also understand that, as an applicant for employment with a youth services provider, providing false information in this application may subject me to prosecution pursuant to § 404 of the District of Columbia Theft and White Collar Crimes Act of 1982 (D.C. Law 4-164; D.C. Code § 22-2405).

References: I hereby authorize Shining Stars Montessori Academy PCS to conduct a background investigation, check references, education and employment history regarding this application for employment, and activities that may relate in any way to my qualifications for employment with Shining Stars Montessori Academy PCS. Further, I authorize any individual, company, business entity, institution or government agency having relevant information to furnish Shining Stars Montessori Academy PCS with that information, without giving me notice of such disclosure.

Employment at Will:
I understand that nothing contained in this employment application or in the granting of an interview creates or implies an employment agreement or contract between myself and Shining Stars Montessori Academy PCS.
I expressly agree and understand that, if employed, my employment is not a specific term, is based on mutual consent and may be terminated by me or my employer with or without notice or cause at any time. I further understand that on oral promise, employer policy, custom, business practice or other procedure (including the basic employment polices, personnel handbook) constitute an employment contract or modification of the at-will employment relationship between me and the employer. I also understand that this aspect of my employment may not change absent an individual written agreement signed by both me and the Executive Director.

I have read and understand the above statements and limitations on and conditions of my possible employment. *
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Signature/Submission Date *
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