Certified Application

Name*

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

What date are you able to begin?*

Date

For which position are you applying? *

Submit your cover letter. *

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Submit your resume. *

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Submit your references. *

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Submit any appropriate licensure needed for the position. *

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Have you ever been terminated from a job or been asked to resign?*

YesNo

Have you received an unsatisfactory evaluation from an employer within the last five years?*

YesNo

Have you ever been convicted of a crime, whether a felony or misdemeanor, other than a traffic infraction?*

YesNo

Do you currently have any pending criminal charges?*

YesNo

Only US Citizens or aliens who have a legal right to work in the US are eligible for employment. Can you, upon employment, provide genuine documentation establishing your identity and eligibility to be legally employed in the United States?*

YesNo

I hereby certify that all the information provided on this application is correct, accurate, and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts will be cause for denial or termination of employment regardless of the timing or circumstances of the discovery. If employed, I agree to conform to the rules, regulations, policies, and procedures of Nettle Creek School Corporation at all times and understand that such obedience is a condition of employment. I authorize Nettle Creek School Corporation to check my employment history, including without limitation, reference checks, and to seek the release of investigator information, including an “expanded criminal history,” possessed by any private or public employer or any local, state, or federal agency. I authorize these private or public employees, or local, state, or federal agencies to provide Nettle Creek School Corporation any information they may release concerning the matters described herein, and I will cooperate to the extent necessary to obtain the release of this information. I expressly waive in connection with any request for, or provision of such information, any claims or causes of action, including without limitation, defamation, infliction or emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against Nettle Creek School Corporation, its officials, employees, trustees or agents, or against any provider of such information. I HAVE READ THIS AUTHORIZATION AND RELEASE OF ALL CLAIMS, AND I EXPRESSLY AGREE TO THE TERMS SETOUT HEREIN.*

AgreeDisagree