Position for which you're applying
First Name
Middle Name
Last Name
Area Code
Phone Number
Home Phone Number Email
Are you a follower of Jesus Christ? YesNo
Current Church Attended Please briefly give your testimony of how you became a Christian.
High School Name Years Attended Graduated? YesNo Degree/Major College Name Degree/Major Years Attended Graduated? YesNo Trade or Correspondence School Years Attended Graduated? YesNo Degree/Major Teaching Experience: Please include dates employed, Employer name, address, and phone number. Position, salary wage, Supervisor's and phone number, and your reason for leaving. Most Recent Position Second most recent position Third most recent position Fourth most recent position Other Relevant Experience: Please list any other experience you have. Including dates, employer name, address and phone number, position, salary supervisor's name and phone number, and reason for leaving. Experience #1 Experience #2 Experience #3 Please list four individuals (including your current pastor) who are very familiar with your professional work and/or character who may be contacted. Please include their name, position, business phone, home or cell phone, and address. In the field below, please respond to each of the following questions: 1. Why do you want to be a teacher for Riverstone Classical Academy? 2. What experience do you have specific to the position you are applying for and how would you use that experience to be a success in Riverstone Classical Academy? 3. Describe your greatest accomplishments as an educator. List degrees, honors, commendations, elective or appointive offices held, or other distinctions received.
Are you, or have you ever been, listed on a sex offender registry? YesNo Are you, or have you ever been, listed on a child or dependant adult abuse registry? YesNo Have you ever been found guilty, accepted a guilty or Alford Plea, or entered a plea of no-contest for any criminal charge? YesNo Have you ever received a deferred judgment, or in some other way had a guilty plea or conviction removed from your record? YesNo If you answered “yes” to any of the above questions, provide date, incident, specific charge, city/state in which occurred: Have you ever been asked to resign from a position, or been given the choice of resigning or being terminated from your position? YesNo Have you ever been the subject of an investigation or other formal/informal proceeding that resulted in the termination of your employment or resignation? YesNo Have you ever been the subject of an investigation into wrong doing or other formal/informal proceeding, resulting in disciplinary or criminal action? YesNo Briefly explain any “yes” response(s): Are you legally eligible to work in the United States? Are you able to perform with or without reasonable accommodation, the essential job functions required of the position? AGREEMENT (Read carefully before signing or submitting electronically) By my signature: • I acknowledge that individuals who provide false, inaccurate, or incomplete information in the application form, in an interview, or any other part of the hiring process or who fail to disclose information requested in the application form, in an interview, or any other part of the hiring process will not be eligible for employment, or, if they are hired, they will be subject to termination. • I acknowledge that to the fullest extent permitted by state and federal law, The Riverstone Classical Academy Board (RCA) will consider all information concerning an applicant or an employee in making hiring, termination, and other employment-related decisions. The term "all information" includes information of any kind (verbal, written, photographic, videographic, etc.) that is accessible in any medium (print, electronic, etc.) from any source. • I acknowledge that RCA will consider public information and other information to which it has lawful access. This may include information that is contained in social networking sites, blogs, and other electronic sites, such as YouTube. If there is information that pertains to me that I believe requires explanation, interpretation, or clarification when it is considered by RCA, it is my obligation to communicate this information to RCA. • I authorize RCA to conduct a complete check regarding my background including, but not limited to, criminal record, child and dependent adult abuse registry screening, and sex offender registry. I agree to prepare and sign any other form necessary to complete a criminal background check. I further authorize all government agencies departments, bureaus, or related entities to release any and all information regarding my criminal history, if any. I agree to immediately notify RCA if I should be convicted of any crime while my application is pending, or during my period of employment, if hired. • I authorize all current and former employers, teachers, and references to release all information regarding my professional competence, performance, character, and background. I waive any right I may have against any person contacted as a reference concerning this application. • I acknowledge that information that is relevant to RCA decisions will be considered regardless of the date on which RCA obtains the information and regardless of the date on which the information was first published, created, or made accessible to RCA. • I understand that this application will be considered active for twelve (12) months from the date filed. I further understand that if I am employed by RCA, this application and associated documents will become part of my permanent record. • I understand that this application is not a contract of employment. In accepting the position, if hired, I understand that employment is at will. I acknowledge that RCA may discharge an at-will employee at any time for any legal reason or no reason at all. • I agree to submit to both pre-employment and post-employment random drug and alcohol testing. By my electronic submission of this form: • I attest that all the information contained in this application is accurate, complete, and true. • I am bound by all elements of the agreement section of the application. • I understand and accept that electronic submission will be considered equivalent to an original hand written signature on a paper copy of the application. Name Date 1. All application materials should be returned to: RiverstoneClassicalAcademy@gmail.com 2. Applicants, and/or their designees, are asked not to contact members of the Board of Directors during this search process. 3. Screening for this position will continue until the position is filled. 4. In order to be considered for this position, your application materials must include the following: a. A letter of application b. Completed application form (including signatures) c. Resume d. Two recent letters of recommendation regarding your professional work (credentials will suffice if the information is current) and two letters of recommendation regarding your character (including a letter from your current pastor e. A copy of (or documented evidence of eligibilty)) f. A letter giving your testimony of how you came to know Jesus Christ as Lord. Riverstone Classical Academy will select for employment qualified applicants for each position without improper discrimination on the basis of race, color, creed, national origin, ethnic background, age, or disability. Persons with disabilities who can perform the essential functions of an assignment with or without reasonable accommodation shall be considered qualified applicants.
