| Last Name: |
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| Middle name: |
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| First Name: |
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| Present Address: |
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| Phone No.: |
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| State: |
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| City: |
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| Street: |
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| Zip: |
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| Address Where You Can Always Be Reached: |
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| Phone No.: |
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| Date of Birth: |
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| Race: |
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| Social Security Number: |
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| POSITION FOR WHICH APPLYING |
| Grade |
| List at least three choices (grade K-6) |
| Elementary: |
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| School: |
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| List only subjects for which certified and # of hours in each subject (grade 7-8) |
| Junior: |
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| High School: |
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| List only subjects for which certified and # of hours in each subject (grade 9-12) |
| High School: |
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| Complete the following questions: |
| Do you possess a valid Oklahoma teaching certificate? |
Yes No |
| Or License? |
Yes No |
| Please indicate the type of certificate you hold: |
Life
Standard
Provisional
License
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| Teacher No.: |
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| Please indicate the field (s) for which your certificate/license is valid: |
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| Please indicate the expiration date of certificate/license: |
Month:
Day:
Year:
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| Are you currently certified in another state (s)? |
Yes
No
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Where?
Type:
Field:
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| Are you currently under contract? |
Yes
No
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Where?
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| Why do you wish to leave your present position? |
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| When are you available to report? |
Month:
Day:
Year:
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Military experience may be counted as teaching experience in Oklahoma for purposes of salary increment and teacher retirement.
Please list branch of service and dates served, if applicable.
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From:
To:
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| Please list any activities or clubs which you would be interested in sponsoring. |
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| Conviction of a felony offense prohibits an individual from serving as a school teacher or administrator in Oklahoma. |
| Have you ever been charged with or convicted of a felony? |
Yes
No
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| If you have a relative who works for Pawhuska Public Schools, or who serves as a member of the Board of Education, please identify and list their names: |
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| Have you ever been involuntarily terminated from the employment of another school district? |
Yes
No
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| If yes, please give the name of the district, the date, and the reasons for termination. |
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Please respond to the statements below as briefly, but as thoroughly, as possible. Your personal views are very important. (Relate each statement to the particular position for which you are applying. Administrative candidates should complete an attached supplemental questionnaire.) |
| Describe what you feel are your most effective techniques or styles of teaching. (Relate to your field). |
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| Describe what you feel are your most effective techniques of student and classroom management. |
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| State your position concerning involvement of teachers in supervision and responsibility outside of the classroom. |
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| In order of priority, list the five (5) most important characteristics of an outstanding teacher. (Relate to your field. |
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| Write additional information that you believe will be helpful in arriving at a true estimate of your qualifications. |
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| OTHER INFORMATION |
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PROFESSIONAL REFERENCES (List only those persons who are qualified to evaluate your qualifications for position sought. Include principals/superintendents
of systems where experience was gained. References must have complete names, addresses and zip codes. Applications who omit suitable professional references
will not be considered. Personal references may be listed on resume.)
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| Cooperating Teacher (Complete if Licensed teacher) |
| Name:
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| Title: | |
| School, School System or College: | |
| Street: | |
| City: | |
| State: | |
| Zip: | |
| Phone: | |
| College Supervisor (Complete If licensed teacher) |
| Name:
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| Title: | |
| School, School System or College: | |
| Street: | |
| City: | |
| State: | |
| Zip: | |
| Phone: | |
| Other: |
| Name:
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| Title: | |
| School, School System or College: | |
| Street: | |
| City: | |
| State: | |
| Zip: | |
| Phone: | |
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