TeacherApplication-PennsylvaniaDepartmentofEducation.docVIP

STANDARD APPLICATION For Teaching Positions in Pennsylvania Public Schools (Please Print or Type) Position(s) Desired Name Last First Middle Professional Personnel ID Present Address Street (Area Code) Telephone City State Zip Code Permanent Address Street (Area Code) Telephone City State Zip Code E-mail Address (if available) List, in order of preference, the grades, subjects and/or positions for which you are applying: 1. 2. 3. CERTIFICATION (list all areas in which you hold valid Pennsylvania and/or out-of-state teaching certificates. Note: Applicants holding a certificate from another state must obtain a Pennsylvania Certificate in order to teach in Pennsylvania Public Schools.) Area of Certification Issuing State Date Issued Have you acquired tenure in Pennsylvania? If yes, in what school district? Date available for employment If you are not employed full time, are you interested in being placed on our Substitute List? Yes No Long-term Yes No Short-term Yes No EDUCATIONAL BACKGROUND School or Institution and Location Major/ Minor Diplomas, Degrees or Credits Earned Grade Point Average (GPA) High School College/University College/University Graduate Study Graduate Study EXPERIENCE (Present or most recent first) Dates Name of Employer and Address Your Title From To (Area Code) Telephone: Work Performed: Reason for Leaving: Name Title of Supervisor: Final Yearly Salary: Dates Name of Employer and Address Your Title From To (Area Code) Telephone: Work Performed: Reason for Leaving: Name Title of Supervisor: Final Yearly Salary: Dates Name of Employer and Address Your Title From To (Area Code) Telephone: Work Performed: Reason for Leaving: Name Title of Supervisor: Final Yearly Salary: Please list activities that you a