Certified Application

ROCHELLE ELEMENTARY SCHOOL DISTRICT NO. 231
CERTIFIED APPLICATION FOR EMPLOYMENT

Rochelle Elementary School District No. 231 is an equal opportunity employer and educator and does not discriminate on the basis of race, religion, color, sex, age, national origin, ancestry, disability, marital status, unfavorable discharge from the military or any other unlawful basis.

Applicants requiring accommodations and/or assistance in the application process should contact the District Office at 815-562-4161, Ext. 5118 .

Personal Information

Present Address

Permanent Address

Same as Above

Date of Application*

Job Preference

List below, in order of preference, the position, grade level or specific subjects for which you are qualified.

Current Certification

List below, in order of preference, the position, grade level or specific subjects for which you are qualified.

Education

List below beginning with the most recent first.

School 1

School 2

School 3

Previous Employment

List below beginning with the most recent first.

Employment 1

Employment 2

Employment 3

References

List three or four persons qualified to give information about you professional qualifications.

Reference 1

Reference 2

Reference 3

Reference 4

Extra Curricular Activities

List below any extra-curricular activities you can direct or coach successfully.

NARRATIVE STATEMENT

In your own words, state why you feel you are well qualified for employment with District No. 231.

Sign and Date

Have you ever been convicted of a crime other than a minor traffic violation?* Yes No

I understand that any materially false statement or omission of fact on this application is sufficient reason to deny an applicant employment and, in the event the applicant is hired, will result in dismissal. I further understand that any omission or false statement of a material term on an employment application is a Class A criminal misdemeanor. Accordingly, I acknowledge that the information provided in this application for employment is true, correct, and complete.

I authorize Rochelle Elementary School District No. 231 to conduct a background check into my prior employment and educational qualifications. I understand that I am subject to a criminal background investigation in accordance with Illinois law. I further understand that I may not be employed by the District if the investigation discloses conviction of any specified offense under Section 10-21.9 of The School Code, 105 ILCS 5/0-21.9, or in accordance with district policy and practice. I hereby authorize the District to initiate a criminal background check by the Illinois Department of State Police and agree to execute any forms required for said investigation.

Signature*

Date*

Instructions to all Certified Applicants

1. All teachers must fulfill state requirements for certification.

2. Only persons with a complete application file and who are deemed to have the best qualifications for specific openings will be called for interviews as openings occur.

3. Please forward a copy of your credentials. Your file will not be complete until credentials are received.

Rochelle Elementary District No. 231
Office of the Superintendant
444 North Eight Street
Rochelle, IL 61068

815/562-6363

Thank you for your interest in working for Rochelle Elementary School District #231. We have received your application. We are reviewing applications currently and expect to schedule interviews shortly. If you are selected for an interview, you can expect a phone call from our Human Resources staff.

Thank you, again, for your interest in Rochelle Elementary School District #231. We do appreciate the time that you invested in this application.

Regards,
Todd Prusator
District Superintendant

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