Pre Employment Application "*" indicates required fields Personal DataName* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Contact Phone*Position PreferencePosition(s) for which you are applying* Employment Desired* Full Time Part Time Tempory Grade/Subject Preference* Example: 1st Grade, Coach. Separate multiple grades with a coma.Select any of the following you are interested in Substitute Teaching Summer School After School Programs Other Foreign Language Ability Add RemoveExample: Spanish, French etc.Do you have certification of bilingual proficiency? Yes No Educational HistoryPlease select highest education level completed.· High School / GEDSelect Years Completed 9 10 11 12 Graduated Type of Degree or Certificate Received Grade Average · Community College / Trade SchoolSelect Years Completed 9 10 11 12 Graduated Type of Degree or Certificate Received Grade Average · College / UniversitySelect Years Completed 9 10 11 12 Graduated Type of Degree or Certificate Received Grade Average · Graduate SchoolSelect Years Completed 9 10 11 12 Graduated Type of Degree or Certificate Received Grade Average ReferencesPlease provide two previous supervisor and one personal referencesReference 1Name First Last Relationship PhoneReference 2Name First Last Relationship PhoneReference 3Name First Last Relationship PhoneResumePlease provide your resume in text format or upload a PDF or Word DocumentUpload Resume PDF or Word fileAccepted file types: pdf, doc, Max. file size: 32 MB.Disclaimer and SignatureBy checking this box I agree to the following below.* AgreeI hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I also agree that falsified information or significant omissions may disqualify me from further consideration for employment and may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date. I authorize all persons listed above (and on the accompanying resume, if any) to give Amigos Por Vida-Friends for Life Public Charter School any and all information concerning my previous employment and education and any pertinent information they may have, personal or otherwise, and release all parties, such persons and Amigos Por Vida-Friends for Life Public Charter School, from liability for any damage that may result from furnishing same to Amigos Por Vida-Friends for Life Public Charter School. If employed by Amigos Por Vida-Friends for Life Public Charter School, I agree to conform to the rules and regulations of Amigos Por Vida-Friends for Life Public Charter School. I further understand that my employment can be terminated, with or without cause of notice, at any time, at the discretion of either Amigos Por Vida-Friends for Life Charter School or myself. I further understand that no manager or representative of Amigos Por Vida-Friends for Life Public Charter School, other than the president of Amigos Por Vida-Friends for Life Public Charter School, has any authority to enter into any agreement, oral or written, for employment for any specified period of time or to make any assurance or promise of continued employment. I understand and agree that I may be required to take a drug and alcohol screening test as part of the pre-employment and at any time during my employment. I hereby give my voluntary consent for a blood and/or urine sample to be collected from me and submitted for testing. I also consent to the release of the test result to Amigos Por Vida-Friends for Life Public Charter School for its use. I understand that any positive drug or alcohol result may preclude my employment. I authorize Amigos Por Vida Public Charter School to obtain a criminal / background check as part of the pre-employment background investigation. If hired, this authorization shall remain on file and shall serve as an ongoing authorization for Amigos Por Vida Public Charter School to procure criminal/background checks at any time during my employment period.