Avenue B and Third Street
P.O. Box 685
Tatum, New Mexico 88267
Print Name (Last)
Present Address City, State, Zip, Present Phone
Permanent Address City, State, Zip, Permanent Phone
Social Security Number Date Available
Have you any limitations which might interfere with your ability to perform the job which you have applied?
Yes No If yes, attach
U.S. Citizen? Yes No
If not, have you permission to work in the U.S.? Yes
LEVEL DESIRED (In Order of Preference)
____Elementary (K-6) _________________________________________________________
(List grades in order of preference)
_____Junior High (7-8) _________________________________________________________
(List subjects in order of preference)
_____High School (9-12) _______________________________________________________
(List subjects licensed to teach in New Mexico)
_____Special Education ________________________________________________________
(List areas of specialization) ___Elem ___Jr High ___HS
(List levels in order of preference)
_____Other: Such as, Counselor, Principal, Nurse, Speech Therapist, Etc.
If you are applying for other than a classroom teacher position, please check OTHER, list position, and complete general information)
List languages (other than English) that you speak, read and write fluently. 1.____________________________
|List Universities and Colleges (most recent first)||City||State||Zip||From To
|Semester Hrs Earned||Degree||Contact Person|
MAJOR/ MINOR FIELD OF STUDY
Bachelor's Degree _____________________________________________________________
Master's Degree ______________________________________________________________
CUMULATIVE GRADE POINT AVERAGE
Bachelor's Degree__________(when A=_____pts.) Master's Degree__________(when
Grade earned__________ Dates__________ grade(s)/ subject(s) taught___________________
School Name City State Supervising Teacher_________________________________________
Have you taken the NTE?____________ If yes, Date_______________
Do you hold a current New Mexico License?__________ Type____________________ Endorsements______________________________
If the answer is no, are you eligible for licensure in New Mexico?_________
Do you hold a license from another state?__________ If so, which states_________________________________________________________
Have you ever had a license revoked by another state?_____yes _____no
PLEASE READ CAREFULLY BEFORE LISTING REFERENCES BELOW
If you have a current, up-to-date placement file with your University,
list the placement office and address.
University Placement Office Address City State Zip
Applicants not registered with placement office should include as references one of the following:
1. If you have taught, list principals, supervisors, and superintendents. (Include last ten years)
2. If you have not taught or have taught less than three years, list
cooperating teacher(s) supervising professor(s), and two professors in
your major field as well as principals, etc when applicable.
List all relevant work experience (most recent first).
|Name of school or agency||Address||City/State/Zip||Name of Supervisor||Dates
|subject or position|
TOTAL NUMBER OF YEARS TEACHING EXPERIENCE________________________
Please give handwritten responses to the following questions. If you are Bilingual, respond in "other than English language", in addition to your English response. (Use additional page(s) if necessary.)
1. Why do you want to work for Tatum Municipal Schools?_____________________________________________________________________
2. Why did you want to become an educator?_____________________________________________________________________
3. What strengths and qualities do you posses that could be an asset
to Tatum Municipal Schools?
4. Give details of special awards or recognitions you have received. ________________________
PLEASE READ CAREFULLY.
This application will be kept on file for 2 years from date of application. If application is not employed within two years and still wishes to be considered, an update application MUST be completed.
1. Have you ever been convicted of a felony or a misdemeanor of moral turpitude?
_____yes _____no If answer is YES, attach full details, including dates, offense, disposition, and current status.
2. Have you ever been placed on probation for commission of a felony or a misdemeanor of moral turpitude? _____yes _____no If answer is YES, attach full details, including dates, offense, disposition, and current status.
3. Are charges pending or have charges ever been filed against you for commission of any offense .
_____yes _____no If so, attach full details, including dates, offense, disposition, and current status.
I certify that answers given herein are true and complete to the best of my knowledge. I authorize TMS to make such investigations and inquiries of my personal, employment, financial, or medical history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools or persons from all liability in responding in inquiries to connection with my employment.
In the event of employment, I understand that false or misleading information
given in my application or interview(s) may result
in discharge. I understand, also that I am required to abide by all policies
and procedures of Tatum Municipal Schools. NOTICE- This application is
not complete without a signature.