SFASD - Applications

SPRING-FORD AREA SCHOOL DISTRICT

DISTRICT OFFICE

199 Bechtel Road

Collegeville, PA 19426

SUPPORT POSITION

APPLICATION FOR EMPLOYMENT

Date of Application ______________________________________

PERSONAL DATA:

Last Name________________First Name_____________________Middle_____________

Social Security #_________________

Present Address:

Street___________________

City___________________State___________________Zip___________________

Telephone (____)_____________

Permanent Address:

Street___________________

City___________________State___________________Zip___________________

Telephone (____)_____________

STATE POSITION DESIRED: ________________________________________________________

Are you interested in being placed on our Substitute List if you are not employed full-time?

 Yes NO

When will you be available for placement? ____________________________________________

Are you at least 18 years of age? _______Yes _______ No

Are you legally eligible for employment in the US? ______ Yes ______ No

EDUCATION:

Name of School	Location	Diploma or Degree Granted	Major and Minor
High School
College
Trade/Technical School

GENERAL:

List any special awards, certificates or licenses issued to you:

______________________________________________________________________________________

List any profession or trade you have _______________________How many years? ________

List any office equipment or machinery you can operate with considerable skill:

______________________________________________________________________________________

This application must be accompanied by Form SP4-164 (Act 34, PA. State Police Criminal Background Check) and (ACT 151, Child Abuse History Clearance)

EMPLOYMENT:

Company or District_______________________________________________________________________________

Address______________________________________________________________________________

Date________________ Position Held__________________________ Salary Range____________

Description of Duties ______________________________________________________________________________________

______________________________________________________________________________________

Company or District_______________________________________________________________________________

Address______________________________________________________________________________

Date________________ Position Held__________________________ Salary Range____________

Description of Duties ______________________________________________________________________________________

______________________________________________________________________________________

If additional space is required, please attach additional pages as necessary.

REFERENCES: Give at least 3 references including the names of previous supervisors who have first hand knowledge of your personal and professional competence. Do not include names of relatives.

Name	Address	Phone	Position of Occupation

It is the policy of the Spring-Ford Area School District not to discriminate on the basis of sex, race, religion, national origin, or disability in its educational programs, activities, or employment policies as required by Title IX of the Education Amendments, Section 504 of Rehabilitation Act, Title VII, and the Americans with Disabilities Act. Inquiries regarding compliance with the foregoing may be directed to the Human Resources Director, Spring-Ford Area School District, Collegeville, Pennsylvania (Telephone 610-705-6000) or the Director of the Office for Civil Rights, Washington, DC, or the Pennsylvania Human Relations Commission, Harrisburg, Pennsylvania.

AFFIRMATION - To be filled out by all applicants:

I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for a refusal to hire or, if hired, dismissal. I authorize any of the persons or organizations referenced in this application to give the Spring-Ford Area School District any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application and release all such parties from all liability for any damage that may result from furnishing such information to you. I authorize you to request and receive such information.

Date ______________________________

Signature ___________________________

NOTE: APPLICANT SHOULD NOT WRITE IN THE SPACE BELOW.

Interviewed by:

____________________________ Date __________________________