A. Personal Information
First:
Middle:
Last:
Suffix:
Home Address:
City:
State:
Zip:
Phone:
Email Address:
Position Applying For:

B. Current Position
Present Title:
Since
Employer Name:
Employer Street Address:
Employer City:
Employer State:
Employer Zip:
Present Annual Salary:
Length of Present Contract:
Current Contract Expiration:

C. Educational Background   Beginning with the most recent, please list all higher education and degrees received.
Institution Name/Location Years attended Degree Major

D. Teaching Experience   Beginning with the most recent, please list all teaching experience.
Position District Name City and State Years Employed
Please explain any gaps in employment (if any):

E. Other Relevant Employment or Experience
Position Employer City and State Years Employed

F. References
Name of Individual Official Position Phone

G. Narrative Response
Why do you want to be an employee at Oasis Academy?

H. Background Information
Have you ever been convicted of a violation of law other than a minor traffic violation? (The term "conviction" includes any conviction, a guilty plea, no contest, a suspended sentence, a deferred sentence, a deferred judgement, or a finding of guilt by a jury or judge)
Yes          No
If "Yes", explain:
 
Have you ever been terminated or discharged, or resigned at the request of your employer, from any job related to K-12 education?
Yes          No
If "Yes", explain:
 
In connection with your professional responsibilities, have you ever been the subject of a complaint or been disciplined by a court or a licensing board of any state?
Yes          No
If "Yes", explain:
 
Are you currently under investigation by any regulatory body for any alleged misconduct or other alleged grounds for discipline?
Yes          No
If "Yes", explain:

I. Current Employment Status
Do you currently hold a valid Nevada Teacher's License with appropriate endorsement for the position you are applying for?
Yes          No
If "Yes", please list your endorsements:

J. Authorization
I hereby certify that the statements made by me in this application and all related information which I have provided are true, accurate, and complete to the best of my knowledge. I understand that if I provide any false, inaccurate, or incomplete information, I will not be eligible for employment, or if I am hired, I will be subject to disciplinary action or dismissal regardless of the date on which Oasis Academy discovers the violation of its policy regarding application form dishonesty.

Accept          Decline

K. Resume
Choose a file to upload: