Section 1/8 - Applicant Information

Prefix

First

Middle

Last

Suffix

Current Address

Apt.

City

State

Zip

Phone

Cell Phone

Do you have a mailing address that is different from your current address?

Yes No

Mailing Address

Apt.

City

State

Zip

Subject/grades for which you wish to be considered (in order of preference):

1st Preference

2nd Preference

3rd Preference

Type of position(s) applying for:

(check all that apply)

Full time Part time Substitute Summer School

Are you able to perform the essential functions of the job for which you are applying with or without reasonable accommodation?

Yes No

Section 2/8 - Christian Commitment

Hawaii Baptist Academy employees are expected to exhibit a Christian lifestyle and be role models to our students both on and off the school campus. Are you able to comply with this statement? *

Yes No

Are you a Christian?*

Yes No

Testimony

Please write a brief testimony about your relationship with Jesus Christ in the section provided below.

Name of church you attend

Denomination

Are you officially a member?

Yes No

Name of pastor

Mailing Address

City

State

Zip

Phone

Section 3/8 - Educational Preparation

Please list, in order of attendance, all educational institutions attended, including high school. Give the total number of semester hours you have earned since your bachelor’s degree was conferred to you. If you did not complete a degree at a particular institution, please indicate the number of credits earned at that institution.

Name of Institution 1

Location (city/state)

Subject Major/Minor

Degree Earned

Yes No

Type of Degree

Semester Hours Earned

Name of Institution 2

Location (city/state)

Subject Major/Minor

Degree Earned

Yes No

Type of Degree

Semester Hours Earned

Name of Institution 3

Location (city/state)

Subject Major/Minor

Degree Earned

Yes No

Type of Degree

Semester Hours Earned

Name of Institution 4

Location (city/state)

Subject Major/Minor

Degree Earned

Yes No

Type of Degree

Semester Hours Earned

Do you now hold (or have you ever held) a state teacher’s credential?

Yes No

Name of Credential 1

Issuing State

Date Issued (mm/dd/yyyy)

Expiration Date (mm/dd/yyyy)

Grade/Subject Listed on Credential

Name of Credential 2

Issuing State

Date Issued (mm/dd/yyyy)

Expiration Date (mm/dd/yyyy)

Grade/Subject Listed on Credential

List any memberships in professional societies.

Please list non-academic activities you are willing to teach.

Are you willing to teach in a team-teaching situation?

Yes No

Are you willing to give individualized instruction?

Yes No

Section 4/8 - Practice/Student Teaching Information

School Name

Address

District

Phone

Grade/Subject taught

Cooperating teacher

Date Picker (mm/dd/yyyy)

Section 5/8 - Prior Teaching Experience

Please list your teaching experience starting with your present or most recent position. You may attach additional pages at the bottom of this form.

School Name

Address

District

Address

Name of principal

Subject/Grade

Service Dates

From (mo./year) to (mo./year)

Reason for leaving

Work Status

Full time Part time Substitute

May we contact this employer?

Yes No

School Name 2

Address

District

Address

Name of principal

Subject/Grade

Service Dates

From (mo./year) to (mo./year)

Reason for leaving

Work Status

Full time Part time Substitute

May we contact this employer?

Yes No

School Name 3

Address

District

Address

Name of principal

Subject/Grade

Service Dates

From (mo./year) to (mo./year)

Reason for leaving

Work Status

Full time Part time Substitute

May we contact this employer?

Yes No

Were you ever suspended, dismissed, or asked to resign from any teaching position?

Yes No

Please explain

Have you ever had a teaching certificate suspended or revoked by any state?

Yes No

Please Explain

Have you every been convicted of any violation of the law (felony and/or misdemeanor) other than minor traffic violations?

Yes No

Please Explain

Section 6/8 - Non-Teaching Experience

Please list your non-teaching experience starting with your most recent position. You may attach additional pages if necessary.

Name of firm/institution 1

Mailing Address

City

State

Zip

Phone

Your position title

Dates of employment

Supervisor's Name and Title

Your duties

Reason for Leaving

May we contact this employer?

Yes No

Name of firm/institution 2

Mailing Address

City

State

Zip

Phone

Your position title

Dates of employment

Supervisor's Name and Title

Your duties

Reason for Leaving

May we contact this employer?

Yes No

Name of firm/institution 3

Mailing Address

City

State

Zip

Phone

Your position title

Dates of employment

Supervisor's Name and Title

Your duties

Reason for Leaving

May we contact this employer?

Yes No

Section 7/8 - References

Please list three professional references (not relatives). If you are applying for a faculty position, please include supervisors and administrators who have observed your classroom performance.

Name of reference 1required

Positionrequired

Email Addressrequired

Phone

Name of reference 2required

Positionrequired

Email Addressrequired

Phone

Name of reference 3required

Positionrequired

Email Addressrequired

Phone

PLEASE PROVIDE THE FOLLOWING:

1. A letter of reference from your pastor.
2. A statement of your philosophy of education.
3. Official college and/or university transcripts from all institutions you attended.

Attach File

Max file size: 10 MB

Attach File

Max file size: 10 MB

Attach File

Max file size: 10 MB

Section 8/8 - Authorization

Certification of Applicant*

I hereby certify that all information contained in this application, including any resume or other information in my application file that I may have submitted, is true and complete and that I have not knowingly withheld any information that is substantially related to the job for which I am applying. I understand that any willful omission or falsification of material facts in my application file may result in my immediate disqualification from consideration for employment with Hawaii Baptist Academy or dismissal if I have already begun working. I also understand that, if hired, my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at the option of either the Company or myself. I understand that no manager or representative other than the President of Hawaii Baptist Academy has the authority to make an agreement contrary to the foregoing. I also understand that this application does not constitute an offer of employment and that background investigations will be conducted to verify information provided by me in my application file or to determine my qualifications for the job I am applying for. Background investigations may include, but are not limited to, physical examinations, reference checks, reviews of my academic and teaching records, work history and verification of my Christian commitment and church attendance. By my signature below, I hereby authorize Hawaii Baptist Academy to conduct such background investigations. I further understand that any information gathered will be confidential and used only in determining my qualifications for employment and assignment.

Yes No

Consent to Use of Electronic Signature*

I agree and consent that the use of a key pad, mouse or other device to select an item, button, icon, checkbox, to enter text, or to perform a similar act/action (e.g., by clicking “Submit”) constitutes my electronic signature and signifies my intent to be bound. I understand that my electronic signature is legally binding, just as if I manually signed a paper document in ink.

Yes No