Certified Job Application

Position Requested*

Answer Required

First Name*

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Last Name*

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Street Address*

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City*

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Zip/Postal*

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Email Address*

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Phone Number*

Number Required

Do you have a valid Arizona Teaching Certificate*

Answer Required

Yes

What Type of Certification and expiration date*

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Langugaes spoken other than English*

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Please provide at least two professional references. They will be contacted via email to complete a reference form prior to employment being offered.

#1 Reference Name and Email*

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#2 Reference Name and Email*

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#3 Reference Name and Email

Answer Required

“YES” answers to the following four questions will not necessarily result in denial of employment. The District will consider all the circumstances, including the date and nature of events which have led to the actions described below. Your written explanation will assist the District in determining your eligibility and suitability for employment. Attach sheets if necessary.

Have you ever been convicted of, admitted committing, or are you awaiting trial for any crime (excluding only minor traffic violations not involving any allegations of drug or alcohol impairment)? You must answer “YES” even if the matter was later dismissed, deferred, vacated or expunged. If you answer “YES”, you must provide dates of the proceedings, the court where the proceedings occurred, a statement of the accusation against you and the final disposition of the case(s).*

Answer Required

Yes

Have you ever had any license or certificate of any kind (teaching certificate or otherwise) revoked or suspended or have you in anyway been sanctioned by law, or is any charge or complaint pending against you before any licensing, certification or other regulatory agency or body, public or private? If you answer “YES”, you must provide the dates of proceedings, name, address, and telephone number of the agency or body where the proceeding took place, a statement of the accusations against you and the final disposition.*

Answer Required

Yes

Are you now being investigated for any alleged misconduct or other alleged grounds for discipline by any licensing, certification or regulatory body (teacher certification or otherwise), or by your current or any previous employer? If you answer “YES”, you must provide the name, address and telephone number of the employer or licensing body and a statement of the accusations against you.*

Answer Required

Yes

Have you ever been convicted of a dangerous crime against children as defined in ARS 13-604.1? If you answer “YES”, provide details including date of conviction, court where convicted, sentence imposed and present status of conviction. *

Answer Required

Yes

Explanation for any of the above questions answered "Yes"

Answer Required

Letter of Interest and Resume*

Answer Required

Choose a file or drag it here.

Letters of Reference from three individuals familiar with your qualifications. a. Beginning teachers should include a Letter of Recommendation from evaluating teacher during student teaching. b. Experienced teachers should include a Letter of Recommendation from an individual responsible for his/her evaluation. *

Answer Required

Choose a file or drag it here.

Copy of Current Certificate and IVP Finger Print Clearance Card*

Answer Required

Choose a file or drag it here.

Copy of Transcripts -unofficial is acceptable for the application process. (NOTE: The District does NOT issue Contracts without Official Transcripts.) *

Answer Required

Choose a file or drag it here.

Under penalty of prosecution and dismissal, I hereby certify that the information presented on this application is true, accurate and complete. I hereby authorize each person, school district and corporation listed on my application to answer any questions that may be asked and to give any information that may be sought concerning this application, my work habits, character, or skills. I authorize the investigation of all statements contained herein and understand that any document relevant to this information may be reviewed by the agents of Murphy Elementary School District #21. I authorize the Murphy Elementary School District #21 to make reference checks regarding my fitness for employment and I will execute such documents to facilitate this investigation. I understand my employment is not finalized until the background investigation has been completed and the Governing Board has officially approved my employment. I understand that misrepresentation or omission of pertinent facts may be cause for dismissal. *

Answer Required

Yes

Signature*

Signature Required

Please fix the highlighted areas below before submitting.

Certified Job Application