dear applicant - new paltz middle · pdf filesubmit your college credential file or three...
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Dear Applicant: This letter is to acknowledge receipt of your resume or on-line application and to thank you for expressing interest in working in our school district. We require an application form, a college credential file or three letters of reference, official transcripts, and proof of certification. We request that you complete the application in as detailed a manner as possible. Please return all materials quickly as your application will not be considered until it is complete.
Thank you for your interest. Sincerely, Melody Kajkowski Office of Certified Personnel Enclosure
Office of Certified Personnel
196 Main Street, New Paltz, New York 12561
Phone: (845) 256-4030 • Fax: (845)256-4027
www.newpaltz.k12.ny.us
New Paltz Central School District 196 Main Street
New Paltz, NY 12561 (845) 256-4000
APPLICATION FOR ADMINISTRATIVE
APPOINTMENT
DO NOT WRITE IN TIllS SPACE
ENCLOSURES:
CREDENTIAL ALE/ REFERENCES
TRANSCRIPTS OTHER ( )
FOLLOW-UP RECORD INITIALS DATE
APPUCATION ACKNOWLEDGED
INTERVIEW-SUPT. OF SCHOOLS
INTERVIEW-
INTERVIEW-
REFERENCES CONTACTED
VISITATION
APPOINTMENT OFFERED
APPOINTMENT ACCEPTED POSITION DATE TENURE TENURE
POSITION AREA DUE DATE BEGINS
Please type or print SCHEDULE STEP SALARY
D~e ________________________________ _
Nwne ______________ ~~~--------------------~~~--------------------------~=_--------ARST MIDDLE LAST
Admess ______________________________________________________________________________ _
_____________________ Telephone C-) ____________ _
Mailing Admess (if different from above ) _____________________________________________________ _
1. Please fill out this application accurately and completely, including certification information. Do not indicate "see resume" or "see vita."
2. Submit your college credential file or three letters of recommendation.
3. Interviews will be arranged by appointment.
4. Application and all supporting documents, including transcripts, copies of certification(s), resume, letter of application, and credential file or letters of reference, should be returned to the Personnel Office in order to be considered for the position.
New Paltz Central School District, 196 Main Street, New Paltz, NY 12561
ADMINISTRATIVE POSITION DESIRED Assistant Superintendent (Specify), ___________________________________________ _
Building Administrator (Specify)
Director or Coordinator (Specify) ___________________________________________________ __
Assistant Principal (Specify): _______________________________ _
Other (Specify) ________________________________ _
Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job-related handicap. The District is interested in diversifying staff to
represent/reflect the cultural diversity of the community. Persons of color are encouraged to apply.
An Equal Opportunity Employer
CERTIFICATION INFORMATION
I hereby certify that I hold a teaching/administrative certificate issued by the University of the State of New York as follows: (Copy exact wording from certificate)
Title ofcertificate _________________ Form, _______________ _
PROVISIONAL, PERMANENT, INITIAL, PROFESSIONAL
Field validity ____________ Type ofSchool _________________ _
SUBJECT AREA OR AREAS ELEMENTARY, SECONDARY, DISTRICT
Valid from ______________ Issued to ____________________ _
DATE IF NAME WAS DIFFERENT
New York Certificate No. ________ ~Date Issued. ___________________ _
A candidate not officially certified to teach in the public schools of New York State outside of New York City should give the status ofhislher application, ifany, as follows (check one):
Application submitted to and approved by the NYS Department of Education, certificate forthcomingO-..-____ _
Application filed - decision pendine>.g-----______ ~Application not filed'--______ _
Other certificates held; type and issuing authority ______________________ _
Were you ever granted tenure in New York State? Yes No __
If so, what School District ____________ Date ofTenure. ____________ _
(please submit a copy of your tenure appointment letter or proof of previous tenure)
If you are a member ofNYS Teachers' Retirement System, please state your number __________ _
SCHOOLS ATIENDED
EDUCATION AND PROFESSIONAL TRAINING (Descending Chronological order)
DATESATIENDED MAJORS & MINORS DEGREE RECEIVED
CURRENT STATUS
CREDITS BEYOND LAST DEGREE
Most recent Professional Position. ______________________________ _
Salary ________________ What salary do you expect?---___________ _
Present position (if different) _______________________________ _
If you are now employed, why are you seeking a change? ______________________ _
When would you be available? _______________________________ _
Have you been fingerprinted? (If yes, provide a copy of clearance ) ____ _
DATES
DATES
DATES
ADMINISTRATIVE EXPERIENCE List in chronological order, most recent Administrative experience first
(include internship teaching if administrative experience does not total three years).
NAME OF LOCATION TITLE NO. YEARS SCHOOL
TEACHING EXPERIENCE NAME OF LOCATION TITLE NO. YEARS SCHOOL
WORK EXPERIENCE - Other than Education
FIRM OR INSTITUTION NATURE OF WORK
REFERENCES
LAST YEAR SALARY
LAST YEAR SALARY
NO. OF MONms
Give four references, including superintendents and principals under whom you have taught, who have first-hand knowledge of your
scholarship and administrative ability. Ifpresently employed, include your present employer.
NAME POSITION PRESENT ADDRESS TELEPHONE NO.
Please place an asterisk before those references we should not contact until you give permission.
I
Have you ever failed to be reappointed, denied tenure, or been discharged from a school position? ________ _
If so, please explain. _________________________________ _
Have you ever been convicted of a felony? ______ _
If so, please explain. _________________________________ _
PERSONAL DATA
What prompted your decision to make application in this School District? _________________ _
Have you ever interviewed at NPCSD? ___ If so, when and what building? _______________ _
What are your professional goals and/or future plans? ________________________ _
Significant professional achievements (articles, group leadership, offices in professional organizations, etc.). _____ _
Name and purpose of community organizations in which you have participated: _______________ _
What experience(s) have you had in working with diverse communities/populations? _____________ _
List any leadership experience you have had in cultural diversity: ____________________ _
How would you characterize your leadership style? _________________________ _
Please provide any information that will assist us in arriving at a fair estimate of your qualifications. ________ _
VERIFICATION
I hereby certify that the above information to the best of my knowledge is true, accurate and complete. Any misrepresentation or willful omissions of facts shall be sufficient cause for disqualification of this application or termination of employment. Furthermore, I hereby authorize the District to conduct work history and personal reference inquiries to determine my acceptability for employment. I acknowledge employment is subject to a fingerprint and criminal check.
Signature of Applicant
Date