Editing previous response:

Please fix the highlighted areas below before submitting.

Auxiliary Personnel Application

Bosqueville Independent School District

7636 Rock Creek Road - Waco, Texas 76708 254-757-3113 www.bosquevilleisd.org

AN EQUAL OPPORTUNITY EMPLOYER

We consider applicants for all positions without regard to race, color, national origin, age, religion, sex, marital status, veteran or military status, the presence of a medical condition, disability, or any other legally protected status.

Please complete the form below. Required fields marked with an asterisk *

Date of Application*

Answer Required

Date Available*

Answer Required

Social Security Number*

Answer Required

Contact Information

PERSONAL DATA

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Street Address*

Answer Required

City*

Answer Required

State*

Answer Required

Zip/Postal*

Answer Required

Email 1*

Answer Required

Email 2

Answer Required

Mobile Phone*

Number Required

Home Phone

Number Required

Work Phone

Number Required

Position Desired: Indicate school levels and subject areas you are prepared to teach. Give preference by ranking in the appropriate level or subject area.

List the position(s) for which you are applying*

Answer Required

Former Bosqueville Employee*

Answer Required

Yes

If yes, when and name at time of employment

Answer Required

Reason for leaving

Answer Required

EDUCATION/TRAINING

Check the highest level of education attained:*

Answer Required

High School graduate

Not a High School graduate

Less than two years of college

two or more years of college

If Classroom/instructional Aides-have passed a rigorous exam demonstrating mastery in reading, writing, and mathematics

Answer Required

Yes

If Not a High School graduate, please list the lasr grade completed below

Answer Required

High School Name/ Address (location)

Answer Required

Check Applicable Option

Answer Required

Diploma

GED

College Name/ Address (location)

Answer Required

Start Date

Answer Required

End Date

Answer Required

Major/Minor Field*

Answer Required

Date Earned

Answer Required

WORK EXPERIENCE

Company/Firm Name

Answer Required

Supervisor Name/ Phone number

Answer Required

Position

Answer Required

Dates Employed

Answer Required

Reason For Leaving

Answer Required

Company/Firm Name

Answer Required

Supervisor Name/ Phone number

Answer Required

Position

Answer Required

Reason For Leaving

Answer Required

Dates Employed

Answer Required

Company/Firm Name

Answer Required

Supervisor Name/ Phone number

Answer Required

Position

Answer Required

Dates Employed

Answer Required

Reason For Leaving

Answer Required

GENERAL INFORMATION

Do you have a relative who serves on Bosqueville ISD Board of Trustees*

Answer Required

Yes

If yes, please provide name and relationship

Answer Required

Please list any languages (other than English) that you can speak, read, or write fluently

Answer Required

List any special/technical skills or knowledge you can contribute to our district

Answer Required

ALL PERSONNEL OF THE SCHOOL DISTRICT, REGARDLESS OF CLASSIFICATION, ARE EMPLOYED, SUBJECT TO ASSIGNMENT, AND/OR REASSIGNMENT BY THE SUPERINTENDENT OR BY HIS OFFICIAL DESIGNATED REPRESENTATIVE BASED UPON THE NEEDS OF THE DISTRICT. DO YOU UNDERSTAND IF EMPLOYED YOU ARE SUBJECT TO REASSIGNMENT AS NEED ARISES?*

Answer Required

Yes

HAVE YOU EVER BEEN CONVICTED OF, PLEAD GUILTY OR NOT CONTEST (NOLO CONTENDRE) TO, OR RECEIVED PROBATION, SUSPENSION, OR DEFERRED ADJUDICATION FOR A FELONY OR OFFENSE INVOLVING MORAL TURPITUDE (INCLUDING, BUT NOT LIMITED TO , THEFT, RAPE, MURDER, SWINDLING, AND INDECENCY WITH A MINOR)?*

Answer Required

Yes

If yes, please state where, when, and the nature of the offense:

Answer Required

CONVICTION OF A FELONY IS NOT AN AUTOMATIC BAR TO EMPLOYMENT. THE DISTRICT WILL CONSIDER THE NATURE, DATE, AND RELATIONSHIP BETWEEN THE OFFENSE AND THE POSITION FOR WHICH YOU ARE APPLYING.

REFERENCES

REFERENCES (GIVE NAME OF SUPERINTENDENTS, PRINCIPALS, MAJOR PROFESSORS, SUPERVISORS OF STUDENT TEACHING, COOPERATING TEACHER, AND ANY OTHERS WHO HAVE OBSERVED AND KNOWN YOUR WORK AS A STUDENT OR TEACHER.) OUR OFFICE MAY CONTACT REGARDING YOUR PROFESSIONAL WORK.

Name

Answer Required

School/Organization

Answer Required

Association

Answer Required

Telephone Number

Number Required

Name

Answer Required

School/Organization

Answer Required

Association

Answer Required

Telephone Number

Number Required

Name

Answer Required

School/Organization

Answer Required

Association

Answer Required

Telephone Number

Number Required

CRIMINAL HISTORY RECORD INFORMATION

The Bosqueville Independent School District is required by Texas Education Code Chapter 22 Subchapter C to review the criminal history of applicants, employees, independent contractors, student teachers, and certain volunteers. The information requested below is necessary to obtain criminal history record information.

Last Name

Answer Required

First Name

Answer Required

Middle Name

Answer Required

Maiden Name

Answer Required

Social Security number

Answer Required

Date of Birth*

Answer Required

Driver's License (State and Number)*

Answer Required

Mailing Address

Answer Required

Sex

Answer Required

Male

Female

Ethnicity

Answer Required

Black

White/Other

Hispanic

Am Indian/ Alaskan Native

Asian/Pacific Islander

I understand that the information I am providing about age, sex, and ethnicity will not be used to determine eligibility for employment but will be used solely for the purpose of obtaining criminal history record information.*

Answer Required

I understand

I acknowledge that Bosqueville ISD has the righ to obtain a Criminal History Record.*

Answer Required

I agree

Signature Name*

Answer Required

Date*

Answer Required

DPS Computerized Criminal History (CCH) VERIFICATION

(AgencyCopy)

I have been notified that a Computerized Criminal History verification check will be performed. (typed signature required below)

Signature Name*

Answer Required

I have been notified that a Computerized Criminal History (CCH) verification check will be performed by accessing the Texas Department of Public Safety Secure Website and will be based on the name and DOB identifiers I supply. Because the anem-based information is not an exact search and only fingerprint record searches represent true identification to criminal history, the organization conducting the criminal history record information obtained using the NAME AND DOB method. Therefore, the agency may request that I have a fingerprint search performed to clear any misidentification based on the result of the NAME AND DOB search. For the fingerprinting process, I will be required to submit a full and complete set of my fingerprints for analysis through the Texas Department of Public Safety AFIS (Automated Fingerprint Identification System). I have been made aware that in order to complete this process I must make an appointment with L1 Enrollment Services, submit a full and complete set of my fingerprints, request a copy to be sent to the agency listed below, and pay a fee of $47.50 to the fingerprinting services company, L1 Enrollment Services. Once this process is completed and the agency receives the data from DPS, the information on my fingerprint criminal history record may be discussed with me.

THIS COPY MUST REMAIN ON FILE BY YOUR AGENCY. REQUIRED FOR FUTURE DPS AUDITS.

I authorize Bosqueville ISD to access the Texas Department of Public safety Website and run a verification check.*

Answer Required

I agree

Signature Name*

Answer Required

Today's Date*

Answer Required

DISPOSITION OF APPLICATION

This application becomes the property of the District. The District reserves the right to accept or reject the application. Applications will be retained and updated for a one-year period, after which the applicant must notify the Personnel Office of his.her desire to remain in an active status. It is the applicant's responsibility to advise the Personnel Office of any change of name, address, or other status while his/her application is active.

VERIFICATION

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection on my application or dismissal from subsequent employment. I authorize the references listed on the previous page to provide Bosqueville ISD any and all information concerning my pervious employement and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing the same to the District. I understand that the District is authorized by Texas Education Code 22.083 to obtain criminal history record information on all applicants the District intends to employ.

I understand that by submitting this application that I am allowing BISD to run all necessary reports.*

Answer Required

I agree

Signature*

Signature Required

Name: Date:

Sign this form

By pressing “Sign Form,” you are agreeing to signing this form electronically.

Signature *

Type to sign

Draw your signature

Full Name *

Date:

Confirmation Email

Confirmation Email *

Email Required

Submitting form...

Protected by reCAPTCHA - Privacy - Terms

Please verify you are not a robot:

Please fix errors above