Let Me Learn Compass Care Job Application
1. Personal Information
Last Name:
First Name:
Middle Name:
City:
State:
Zip:
Home Phone:
Fax:
Address:
Email:
Authorized to work in the U.S.?
YES/NO
Current Legal Status:
Date Available for Interview:
Date Available for Employment:
2. Positions Applied For
FullTime:
PartTime: Day Care Staff
Substitute:
List Subject/Grade level(s) or non teaching by preference:
Undefined
Level: N/A
Type: N/A
3. Credential(s) Now Held or Applied For
(Including out-of-state)
Type:
State:
Expires:
Minor:
If new credential applicant, date applied: N/A
4. Educational Work Experience
(Under Contract and Credentialed)
Start Date:
End Date:
Grade/Subject/Position:
School Name:
School Address:
District Name:
State/Province:
Phone:
Supervisor:
Supervisor's Email:
Reason for Leaving:
If presently under contract, have you checked and can you be released if you are offered a position? YES/NO
5. Student Teaching Experience (if applicable)
Start Date:
End Date:
Grade/Subject:
School Name:
Cooperating
Mentor/Teacher Name:
Email completed application to: joel@letmelearn.org.
Be sure to attach a resume in addition to this application.
Let Me Learn Compass Care Job Application
District Name:
State/Province:
Phone:
6. Non-Educational Employment
(including military experience)
Start Date:
End Date:
Organization Name:
Address 1:
Address 2:
Phone:
Position:
Supervisor:
Reason for Leaving:
7. College/University Education
School Name:
School Location:
Start Date:
End Date:
Degree/Diploma:
Major:
Minor:
Number of Semester Units of Graduate Work Beyond BA =
(1 Quarter Unit = 2/3 Semester Units)
8. Volunteer
Start Date:
End Date:
Agency Name:
Phone:
Position:
9. Professional Reference
(Include a minimum of 3 who have knowledge of your teaching experience)
Name:
Position/Relationship:
School District:
Address:
Work Phone:
Home Phone:
10. Special Skills, Interests, and Training
Please specify any language(s), (other than English), including sign language, in which you are proficient:
Name:
Speak:
Read:
Write:
This area is provided for you to give us additional information about yourself such as special skills, and interests:
Email completed application to: joel@letmelearn.org.
Be sure to attach a resume in addition to this application.
Let Me Learn Compass Care Job Application
Special Training:
11. Other Information
Has your credential ever been suspended or revoked?
YES/NO
Have you ever been dismissed or asked to resign from a position?
YES/NO
Have you ever entered a plea of guilty or been convicted of a felony or misdemeanor?
YES/NO
For each of the above questions answered "YES", explain the circumstances below:
Please list tests that you have passed and enter any other additional Information below:
By submitting this application, I HEREBY CERTIFY that all statements made hereon are true and correct to the best of
my knowledge, and I authorize the investigation of all statements herein recorded. I release from all liability persons and
organizations reporting information required by this application. I understand that any omission, false answered
statement made by me on this application, or any supplement to it will be sufficient grounds for failure to employ or for
my discharge should I become employed with the school district.
Name of Applicant:
Date
Attached Resume:
Email completed application to: joel@letmelearn.org.
Be sure to attach a resume in addition to this application.