NORTH LAWRENCE COMMUNITY SCHOOLS
Administrative Service Center
460 W Street, P.O. Box 729
Bedford, IN 47421
Telephone (812) 279-3521
Action By Employing Officials  
Initial and Date After Reviewing
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School Administration
Application
Please fill out blanks with complete, detailed information.
You are encouraged to attach a vita sheet.
     
Name:
Date of Application: 6/25/2019
  First Middle Maiden Last  
     
Present Address:
Home Phone Number:
     
City/State/Zip:
Office Phone Number:
     
Email Address:
Present Position:
 
 
Note: Before Employment, A Personal Interview is Necessary
Have you previously applied for a position in this school system? Yes No    Date
 
Please list the types of positions you desire, in order of preference:
(1) (2) (3)
 
 
Organizational Affiliation
Organization
Position
Remarks
 
 
License Information
Type of License
(Elem., Sec., etc)
Provisional
Or Professional
Date of
Issue
Date
Expires
Serial
Number
Subject Area
Mentorship Required: Yes No
 
Education and Professional Training
Type of School Name & Location of Schools Courses Majored In Degree or Diploma
High School Diploma Yes No
College List Degree
Sem. Hrs.
College List Degree
Sem. Hrs.
Graduate School List Degree
Sem. Hrs.
Other:          
Scholastic Standing in High School    In College
 
 
Work Experience Other Than Teaching In Last Five Years
Name and Location Of Company
(Begin with most recent)
Kind Of Business From
ex) 01/2001		 To
02/2004
Reasons For Leaving
         
Professional Experience
Name and Location Of School
(Begin with most recent)
Position From
ex) 01/2001		 To
02/2004
Reasons For Leaving
 
References
Give references including Supervising Teachers, Principals, and Superintendents under which you have taught or student taught.
  Name Address Official Position
1.
2.
3.
4.
5.
Name under which transcripts and employment records may be indentified if different from your present name:
College Placement File Number; if known No. College:
  No. College:
 
Transcript: Sent For Received Credentials: Sent For Received
Notification Promised By Letter Phone
 
Important Salary Information
The basis upon which salary would be computed    
  Number of years of military service   Check All Degrees Received:
  Number of years teaching   BS
  Number of years Administration   BA
        MS
 
Total:
   MA
        Ed. Spec.
        Ed. D.
  Semester hours above masters' degree   Ph. D.
Who referred you to this school district?
Date available to begin employment:
In a short statement below, tell us why you have applied for a position in the North Lawrence Community Schools
I hereby certify that to the best of my knowledge the foregoing statements are true and complete. I further understand that this application will become a part of my permanent personnel file should I become employed by the North Lawrence Community Schools. I also signify by submitting this application electronically that permission is given for this prospective employer to receive and view any copies of my school or college record, or any references that I or the school system may select without my inspection of the information.
 
 
 
__________________________________________________
__________________________________________________
Signature
Date
 
Note: This application will be kept active for two (2) years unless employed during that time.

If you are hired for a position with North Lawrence Community Schools, administrative personnel must process a criminal history check. The applicant will be required to cover the cost for the criminal history check. If you are hired for a position with North Lawrence Community Schools, administrative personnel must process a criminal history check/child abuse registry check. You will receive an invitation by email from the personnel department to process this information through Safe hiring solutions and payment will need to be made by credit/debit card.

An authorization form must be completed before the Criminal History check is done.
The North Lawrence Community School Corporation does not discriminate against any individual because of race, sex, color, religion, creed, age, national origin, or physical handicap in the operation of its educational programs or activities.