Teacher Application Personal InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Daytime Phone*Cell Phone*Email* Religion*Faith*Parish/Church*Employment InterestsSubject Area(s)*Extra-Curricular Interests (Coaching, activities, etc.)*Educational and Professional Training*College or UniversityLocation (City, State)Dates Attended From - ToGraduation Date, Degree Undergraduate DegreeMajor(s)Minor(s)Graduate DegreeGraduate DegreeArea(s) of ConcentrationTeaching ExperienceDates From - ToSchoolLocation (City, State)Grade(s) or Subject(s) Other Related Work ExperienceDates From - ToCompany, Job Title (Short job description, if needed)Location (City, State) Professional References (for each of the positions listed above)NameSchool/CompanyDaytime PhoneEmail Background QuestionsDo you possess a valid teaching certificate?*YesNoIf yes,State(s)Type(s)/Teaching Area(s)Expiration Date(s) Have you ever had a teaching credential denied, suspended, or revoked?*YesNoIf yes, please explain:Have you ever failed or refused to fulfill an employment contract with any school?*YesNoIf yes, please explainHave you ever for any reason been suspended, dismissed, or asked to resign a teaching position?*YesNoIf yes, please explain:Have you ever been convicted of a crime? (excluding minor traffic violations or convictions that have been sealed, expunged, or legally eradicated)*YesNoIf yes, briefly describe the nature of the crime(s), the date and place of the conviction, and the legal disposition of the case:After employment, can you submit verification of your legal right to work in the United States?*YesNoWould your involvement (attendance, participation, supervision) in religious activities make you feel uncomfortable or compromise any of your own personal beliefs?YesNoIf yes, please explain:Short AnswerWhy would you like to work at Cristo Rey Columbus High School?*What are the strengths you bring to the education profession?*What is your understanding of “data-driven instruction” and what experience do you have in a data driven classroom?*How would you differentiate instruction to meet the needs of the many learners in your class?*How would you integrate technology into your classroom (we are a 1:1 iPad school)?*How would you describe your classroom management style?*Cover Letter: Drop files here or Resume: Drop files here or Certification*I hereby certify that all the information given in the application form and any supporting documentation (resume, transcripts, credentials, etc.) is true, complete, and correct. I understand that any misrepresentations or omissions shall be sufficient cause for disqualification or, if hired, dismissal. I authorize investigation of all statements contained in this application and any supporting documentation. I further authorize Cristo Rey Columbus to secure information from former employers, educational institutions, governmental agencies, social media or any references I have provided and for those parties to provide information concerning my experience. I hereby release and hold harmless all parties from any liabilities arising from such investigation and verification. I consent.