Notus Classified Application

Classified Application Notus School District 135 25257 Notus Road Caldwell, ID 83607 Office: (208) 459-7442 Fax: (208) 453-1027 www.notusschools.org An Equal Opportunity/Affirmative Action Employer
Date*

MonthDayYear
Date
Last*
First*
Middle
SSN
Address*
Phone*
Format: (000) 000-0000.
email address*
example@example.com
YesNo
Please indicate your expected hourly/annual salary for this/these positions
Please list the positions for which you are applying in order of preference.
1*
2
3

Educational Training - List in order of attendance. Use additional sheets if necessary.*

Rows	School	City & State	Dates of Attendance	Diploma or Degree	Major
1
2
3

Experience - List most recent experience first. Use additional sheets if necessary. Three written references must be on file.*

Rows	Employer Name, Address & Telephone	Superintendent Or Supervisor	Dates of Employment	Position Held	Reasons for Leaving
1
2
3

References - Three written references must be on file.*

Rows	Name	Relationship	Address	Telephone	Years Known
1
2
3

YesNo
Explain your answer
YesNo
Explain your answer
YesNo
Explain you answer
YesNo
YesNo
Please state below why you feel you are the best candidate for this position. Be sure to list those qualities that you believe qualify you for this position.
Employment will be based on the following procedures unless otherwise noted on vacancy listing:

1. Preliminary screening of applicants will be based on ability to meet job description requirements as evidenced by completed application. Supportive job-related information not on this form may be submitted by the applicant. Any materials received at the district office more than 10 days after the application deadline will not be accepted.

2. By signing this form, applicant consents to be fingerprinted and submit to a background check as required by Section 33-130 of Idaho Code and further to furnish results of said background check to Notus School District 135.

3. Additional data will be requested from the candidate or from disclosed references such as letters of recommendation and other information as determined by Notus School District 135.

4. Finalists will be required to attend a personal interview at the Notus School District Office.

5. A recommendation for employment will be submitted to the Board of Trustees.

6. Notification of employment will be sent to the candidate.

I hereby certify that the information herein is a true and complete statement of my personal and professional record to date.
Signature of Applicant*

Clear
Date*

MonthDayYear
Date
CRIMINAL HISTORY BACKGROUND STATEMENT
Applicants Note: Answer all questions on this form. Incomplete information may cause your application to be delayed or rejected.
PLEASE PRINT THE FOLLOWING IN THE APPROPRIATE BOXES
State*
Driver License Number*
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Sex
Social Security Number
Address*

Address

Street Address Line 2

CityState

Zip
Telephone*
Format: (000) 000-0000.
List maiden other names previously used
List other states where you have resided as an adult above 18 yrs of age*
YOU MUST CHECK YES OR NO TO EACH QUESTION BELOW.
YesNo
If the answer is no, please explain:
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
If you have answered yes to any of questions 2-20 please explain below:
AUTHORIZATION FOR RELEASE OF INFORMATION ON PAST EMPLOYMENT WITH SCHOOL EMPLOYERS IDAHO CODE 33-1210
Idaho Law requires applicants for any position at any Idaho Public School to allow the hiring school district employer to obtain a copy of past public school employer personnel file materials and other documentation relating to the performance of the applicant when such applicant was employed by any other public school, whether in Idaho or any other

Before hiring an applicant for any position, the District must request the applicant to sign this form. Should the applicant refuse or fail to sign this form, the District is not permitted to hire the applicant for any position. This authorization does not limit any employer from seeking additional information or disclosures from any applicant.

This form: 1.Authorizes current and past public school employers of the applicant/undersigned on this form, including applicants outside the State of

Idaho, to release to the hiring school district all information relating to the job performance and/or job related conduct of the applicant and make available to the hiring school district copies of all documents in the previous employer's personnel file, investigative file or other files relating to the job performance of the applicant; and Releases the applicant's/undersigned's current and past employers, and employees acting on behalf of the employer, from any liability for providing the

33-1210 RELEASE I understand that the above requirements are a condition of my obtaining employment with the District and I consent to my current and former employers, both inside and outside the State of Idaho, upon receipt of this signed authorization, to comply with Idaho law. I further consent that such authorization may be provided to the hiring District via electronic means.
Signature of Applicant*

Clear
Date*

MonthDayYear
Date
Printed Name of Applicant*
Identifying Employee Number/Name of Applicant or other Identifying Information (other last names used) for Past Employer:
Information obtained through the use of this release will be used only for the purpose of evaluating the qualifications of the applicant for employment. This information will not be disclosed in any manner other than as provided by Statute:
- A copy of this release and all other information obtained through use of this release will be placed into the applicant's personnel file with the District upon employment of the applicant, if any.
- An applicant's failure to disclose any former school district employer, whether within or outside of the State of Idaho, will serve as the basis for immediate termination and, for certificated personnel, may also result in the District's reporting of the individual to the Idaho Professional Standards Commission for a potential violation of the Code of Ethics for Professional Educators.
- By accepting an executed copy of this form, the hiring school district makes no guarantee or promise of employment to the applicant. Further, the hiring school district may employ the applicant on a conditional basis pending review of information gathered pursuant to this release. Such conditional employment is not a guarantee or promise of continued employment with the hiring school district for any length of time or pursuant to any additional conditions.
Should be Empty:

Classified Application Notus School District 135 25257 Notus Road Caldwell, ID 83607 Office: (208) 459-7442 Fax: (208) 453-1027 www.notusschools.org An Equal Opportunity/Affirmative Action Employer

CRIMINAL HISTORY BACKGROUND STATEMENT

PLEASE PRINT THE FOLLOWING IN THE APPROPRIATE BOXES

AUTHORIZATION FOR RELEASE OF INFORMATION ON PAST EMPLOYMENT WITH SCHOOL EMPLOYERS IDAHO CODE 33-1210