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Application in Progress

You are applying for Coordinator, HS Athletics-Head Coach (425).

Application Progress
  • Personal Information
  • Personal Information Continued
  • Pre-Employment Affidavit for A
  • Background Information
  • Background Information Part 2
  • Education
  • Employment History
  • Job Skills
  • Job Skills Technology
  • SBEC Certification Authorizati
  • References
  • Attachments
  • Resume & Cover Letter
  • PDAS / ILD Certification Compl
  • Review
Review Your Information

Your application is not complete until you hit the "Save and Submit" button at the bottom of this page and receive a confirmation number.

Policy, Privacy Policy, and Disclaimer

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Personal Information

General Information

How did you learn about this position?

Contact Information

First NameLast Name
Middle NameOther Name
EmailPrimary Phone
Alternate PhoneSocial Security Number
Have you worked here before?Maiden/Former Name
Alumni

Present Address

StreetCity
StateZip Code/Postal Code

Permanent Address

(If different from Present Address)

StreetCity
StateZip Code/Postal Code
Telephone

Equal Opportunity Information

Addendum To Application:
The Bastrop Independent School District may by law obtain criminal history record information on all applicants for employment with the district (Texas Education Code Section 22.083). The information requested below is necessary to obtain criminal history record information.

Release Statement:
I understand the information I am providing about age, sex, and the ethnicity will not be used to determine eligibility for employment, but will be used solely for the purpose of obtaining criminal history record information.
I understand the Bastrop ISD has a policy that prohibits it from offering me a job until it receives and reviews my criminal history. In consideration of the Bastrop ISD waiving its policy and tentatively offering me a job subject to its review of my criminal history, I hereby agree and acknowledge that the Bastrop ISD, in its sole discretion and for any reasons whatsoever, may revoke its tentative job offer to me upon receipt and review of my criminal history record.

Date Of BirthDriver License Number
Driver License StateGender
Personal Information Continued

Personal Information Continued

Are you retired and receiving an annuity from the Texas Teacher Retirement System?
Pre-Employment Affidavit for Applicant

Pre-Employment Affidavit for Applicant

1. I have been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor.
2a. I have been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor. The charge, adjudication, or conviction was determined to be false.
2b. The following are all of the relevant facts pertaining to the charge, adjudication, or conviction:
3a. I have been charged with, adjudicated for, or convicted of having an inappropriate relationship with a minor. The charge, adjudication, or conviction was determined to be true.
3b. The following are all of the relevant facts pertaining to the charge, adjudication, or conviction:
Name (first, middle, last):Date of Birth
Address (Street, City, State, Zip Code)County
This affidavit is offered to satisfy the requirement of Texas Education Code section 21.009 for a pre-employment affidavit, in accordance with Texas Civil Practices and Remedies Code section 132.001. An applicant who is offered employment will be asked to complete a notarized affidavit attesting to the same.


For purposes of this affidavit:
    Adjudication and conviction refer to a conviction, plea of guilty or no contest (nolo contendre), probation, suspension, or deferred adjudication.

    Charge refers to a formal criminal charge as documented by a primary charging instrument (a complaint, information, or indictment) under the Texas Code of Criminal Procedure.

    Inappropriate relationship refers to the crime of improper relationship between educator and student in Texas Penal Code section 21.12, and any other inappropriate relationship as determined by the State Board for Educator Certification.

I understand that the date of birth I am providing will not be used to determine eligibility for employment but will be used solely for the purpose of this pre-employment affidavit.


I declare under penalty of perjury that the foregoing is true and correct.



Today's Date
Background Information

Background

Conviction of a crime is not an automatic bar to employment. The district will consider the nature of the offense, the date of the offense, and the relationship between the offense and the position for which you are applying.

Have you ever been convicted of a violation of law other than a minor traffic violation?
If yes, please explain
Have you ever had a professional certificate revoked or suspended?
If yes, please explain
Have you been convicted of any offense for physical or sexual abuse of a child?
If yes, please explain
Have you ever had a charge of child abuse against you substantiated?
If yes, please explain
Have you ever been involuntarily terminated or asked to resign, or resigned in lieu of termination from the employment of another school district?
If yes, please give the name of the district, the date and the reason for the resignation or termination
If yes, please give the name of the employer, the date and the reason for the resignation or termination
Have you ever been involuntarily terminated or asked to resign, or resigned in lieu of termination from another employer?
Have you ever had a professional license revoked or suspended?
Background Information Part 2

Background Information Part 2

Have you ever served probation or had a sentence of deferred adjudication?
If yes, please provide an explanation.
Education

Secondary/High School Information

School AttendedCity/State
Degree

Undergraduate Institution #1

Type of SchoolName of School
CityState
Attended From (mm/yyyy)Attended To (mm/yyyy)
Graduation Date (mm/yyyy)Degree
SubjectGPA

Undergraduate Institution #2

Type of SchoolName of School
CityState
Attended From (mm/yyyy)Attended To (mm/yyyy)
DegreeSubject
Graduation Date (mm/yyyy)GPA

Graduate Institution #1

Name of SchoolCity/State
From (mm/yyyy)To (mm/yyyy)
DegreeDegree Subject
Graduation Date (mm/yyyy)Semester Hours Credit
GPA

Graduate Institution #2

Name of SchoolCity/State
From (mm/yyyy)To (mm/yyyy)
DegreeDegree Subject
Graduation Date (mm/yyyy)Semester Hours Credit
GPA

Graduate Institution #3

Name of SchoolCity/State
From (mm/yyyy)To (mm/yyyy)
DegreeDegree Subject
Graduation Date (mm/yyyy)Semester Hours Credit
GPA

Course of Study

Master'sSpecialist's
DoctoratePublications
Activities/Honors
Employment History

Present Position

Present TitleSalary
Name of EmployerEmployer's Address
Employer's CityEmployer's State
Start DateSupervisor Name
Supervisor Phone NumberSupervisor Email
Reasons for Leaving
May we Contact this Employer

Professional Experience #1

From (mm/yyyy)To (mm/yyyy)
School/Complete Address
AssignmentReason For Leaving
SalaryMay we Contact this Employer

Professional Experience #2

From (mm/yyyy)To (mm/yyyy)
School/Complete Address
AssignmentReason For Leaving
May we Contact this Employer

Professional Experience #3

From (mm/yyyy)To (mm/yyyy)
School/Complete Address
AssignmentReason For Leaving
May we Contact this Employer

Experience Summary

Actual experience in a scholastic environment (with the exception of non-academic experience).

Years of teaching experienceYears of student teaching experience
Years of administrative experience
Job Skills

Certification Information/Professional Certificate #1

Certification AreaCertification Area Type
Grade LevelExpiration Date
Certification State

Certification Information/Professional Certificate #2

Certification AreaCertification Area Type
Grade LevelExpiration Date
Certification State

Certification Information/Professional Certificate #3

Certification AreaCertification Area Type
Grade LevelExpiration Date
Certification State

Certification Information/Professional Certificate #4

Certification AreaCertification Area Type
Grade LevelExpiration Date
Certification State

Out of State Certification Information

Certification Area
Details
Job Skills Technology

Job Skills Technology

Technology Work Experiences

Please list the web applications that you feel confident using for productivity/instruction:
Describe your past experiences with technology in the workplace or classroom.
How would you integrate technology into this position?
SBEC Certification Authorization

SBEC Certification Authorization

The Bastrop ISD Human Resources Department is an authorized user of the TEA Educator Certification Online System (ECOS) System. Pursuant to Texas Education Code 21.048(c-1), the results of all certification examinations are confidential and prohibited from disclosure under the Texas Public Information Act.

Do you consent to allow Bastrop ISD to view the result of your certification exam(s) for hiring purposes?
References
Attachments

Attachment

Resume & Cover Letter

Resume & Cover Letter

Cover Letter
PDAS / ILD Certification Completion

PDAS / ILD Certification Completion

Have you completed PDAS and ILD training requirements?
Background Check

AUTHORIZATION FOR CONSUMER REPORTS

I hereby authorize procurement of consumer report(s) and investigative consumer report(s) by the Bastrop Independent School District. If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for the Bastrop Independent School District to procure such reports at any time during my employment, contract, or volunteer period. I authorize without reservation, any person, business or agency contacted by the consumer reporting agency to furnish the above-mentioned information.

This authorization is conditioned upon the following representations of my rights:

I understand that I have the right to make a request to the consumer reporting agency: JD Palatine, LLC ("Agency"), 8000 Brooktree Road, Suite 210, Wexford, PA 15090, (724) 799-8580 upon proper identification, to obtain copies of any reports furnished to Company by the Agency and to request the nature and substance of all information in its files on me at the time of my request, including the sources of information, and the Agency, on the Bastrop Independent School District’s behalf, will provide a complete and accurate disclosure of the nature and scope of the investigation covered by any investigative consumer report(s). The Agency will also disclose the recipients of any such reports on me which the Agency has previously furnished within the two-year period for employment requests, and one year for other purposes preceding my request. I hereby consent to the Bastrop Independent School District obtaining the above information from the Agency. I understand that I can dispute, at any time, any information that is inaccurate in any type of report with the Agency. I may view the Agency’s privacy policy at their website: www.assuredoccu.com.

I understand that I have rights under the Fair Credit Reporting Act, and I acknowledge receipt of the Summary of Rights

(XXX-XX-XXXX)
//  (MM-DD-YYYY)

(type your full name)
District Policy

The School District does not discriminate on the basis of race, color, national origin age, sex or disability, in admission or access to, or treatment or employment in its programs and activities. Any person having inquiries concerning the School's compliance with the regulations implementing Title VI of the Civil Rights Act of 1964 (Title VI), Section 504 of the Rehabilitation Act of 1973 (Section 504), or Title II of the Americans with Disabilities Act of 1990 (ADA), may contact the Assistant Superintendent or Human Resources.

Application Confirmation Statement

I affirm that all information set forth in this application is accurate, truthful and complete. If I am employed by the School District, I will abide by all Board of Education and school policies, work on assigned committees, and continue my professional growth to the best of my ability and within reasonable and personal standards. I grant permission for school officials to obtain a personal record check from the federal, state, county, and/or local law enforcement agencies and Division of Family Services; also a credit history check may be made. I release individuals listed as references and current or former employers from any liability for information given in response to a request for an employment reference. I understand that I will be required to take a drug test and physical exam prior to assuming any position for which I may be employed. In the event that I am employed by the District and in the further event that I have provided false or misleading information in this application or in subsequent employment interviews, I understand that my employment may be terminated at any time after the discovery of the false or misleading information. I understand that this application will be considered active for one year from date of submission.

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