Regional School District Common Application

within the St. Lawrence-Lewis BOCES Component School Districts

Basic Information

St. Lawrence-Lewis BOCES and its component school districts (Districts) do not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups. The Districts are equal opportunity employers. Each District has an employee designated to handle inquiries regarding the non-discrimination policies. Please refer to the individual school district or BOCES' website for the contact information.
Inquiries concerning the application of the District's non-discrimination policies may also be referred to the US Department of Education, Office of Civil Rights (OCR), 32 Old Slip, 26th Floor, New York, NY 10005, telephone (646) 428-3800 (voice) or (800) 877-8339 (TTY).
NOTICE: Please use the MOST RECENT VERSION of your BROWSER. If you do not, it is likely your application will not be submitted. This form will time out at 20 minutes.
First Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Last Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Middle Initialfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Addressfield type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country

Telephone Number/Email:

	Telephone Number:field type single line	Typefield type radio button	Email Address:field type single line
Row 1×	Telephone Number:field type single line Input blocked. Maximum character limit of 4000 characters reached.	Typefield type radio button TypeHomeOfficeCell	Email Address:field type single line Input blocked. Maximum character limit of 4000 characters reached.	×

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Social Security Number*field type single line
xxx-xx-xxxx
Input blocked. Maximum character limit of 4000 characters reached.

Certification

	Type of Certification/Licensefield type single line	Statefield type single line	Numberfield type single line
Row 1×	Type of Certification/Licensefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Statefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Numberfield type single line Input blocked. Maximum character limit of 4000 characters reached.	×

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Have you ever been appointed on tenure in a public school system in NYS?field type radio button
Have you ever been appointed on tenure in a public school system in NYS?YesNo
Name and address of school district where tenure was grantedfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Tenure Areafield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Have you ever been fingerprinted for the purpose of obtaining employment with a NYS public school district?field type radio button
Have you ever been fingerprinted for the purpose of obtaining employment with a NYS public school district?YesNo
Click Here For : Fingerprinting Information
Have you ever been dismissed from employment for cause?field type radio button
Have you ever been dismissed from employment for cause?YesNo
Have you ever resigned from a position to avoid the effects of a denial of tenure?field type radio button
Have you ever resigned from a position to avoid the effects of a denial of tenure?YesNo
Have you ever resigned as an alternative to facing any type of charges or dismissal?field type radio button
Have you ever resigned as an alternative to facing any type of charges or dismissal?YesNo
Have you ever been convicted of a criminal offense?field type radio button
Have you ever been convicted of a criminal offense?YesNo

Education

	Schoolfield type single line	City/Statefield type single line	Degreefield type single line	Years Completedfield type single line
HS	Schoolfield type single line Input blocked. Maximum character limit of 4000 characters reached.	City/Statefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Degreefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Years Completedfield type single line Input blocked. Maximum character limit of 4000 characters reached.
Undergrad	Schoolfield type single line Input blocked. Maximum character limit of 4000 characters reached.	City/Statefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Degreefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Years Completedfield type single line Input blocked. Maximum character limit of 4000 characters reached.
Grad	Schoolfield type single line Input blocked. Maximum character limit of 4000 characters reached.	City/Statefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Degreefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Years Completedfield type single line Input blocked. Maximum character limit of 4000 characters reached.
Other	Schoolfield type single line Input blocked. Maximum character limit of 4000 characters reached.	City/Statefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Degreefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Years Completedfield type single line Input blocked. Maximum character limit of 4000 characters reached.

Student Teaching Experiencefield type radio button
Student Teaching ExperienceYesNo
Experience (most recent first):
×
- Please provide information covering employment experience, including time spent in military service, if any. Use the comments area at the end of this section on experience to account for any gaps in your employment.
- Name of Employer:field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Employer Address:field type address
  Street Address
  Address Line 2
  City
  State / Province / Region
  Postal / Zip Code
  Country
- Name and Title of Your Supervisor:field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Phone Number:field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Your Job Title:field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Start Date:field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- End Date:field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Reason for Leaving:field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- In detail, describe the work you did:field type multi line
Add

Comments on your work experience:field type multi line
List any applicable volunteer experience:field type multi line
Please give any other information on your experience or abilities which you believe would assist in evaluating your qualifications:field type multi line

Please upload a copy of your resume, transcripts, certifications, 3 letters of reference and any other applicable material:

File Uploadfield type file upload
You have reached the maximum file limit: 10.
pdf, docx only (doc, txt, and jpeg documents will not be accepted)

References:

List any other persons, not relatives, who have personal knowledge of your employment or educational capabilities (minimum of three):

	Name/Occupationfield type single line	Addressfield type single line	Telephonefield type single line	Relationshipfield type single line
Row 1×	Name/Occupationfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Addressfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Telephonefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Relationshipfield type single line Input blocked. Maximum character limit of 4000 characters reached.	×
Row 2×	Name/Occupationfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Addressfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Telephonefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Relationshipfield type single line Input blocked. Maximum character limit of 4000 characters reached.	×
Row 3×	Name/Occupationfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Addressfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Telephonefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Relationshipfield type single line Input blocked. Maximum character limit of 4000 characters reached.	×

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NOTICE: (New York State Penal Law Section 210.45) - A person is guilty of making a punishable false written statement when (s)he knowingly makes a false statement, which (s)he does not believe to be true, in a written instrument bearing a legally authorized form notice to the effect that false statements made therein are punishable. Making a punishable false written statement is a Class A Misdemeanor.
Please read this application and the following authorization over carefully, and sign below:
The information which I have provided on this application is true and complete. I understand that any incorrect or misleading information is cause for rejection of this application or dismissal from a job if I have been employed.
I grant my permission to the Schools that I have checked to contact former and current employers, law enforcement agencies, educational institutions, licensing/certifying agencies, and personal references. I authorize any and all of the above individuals and agencies to provide the selected Schools with the information requested, so long as the information given is relevant to the job duties/responsibilities for which I have applied, and I hereby release from liability any such individual or agency contacted by the Schools selected in connection with my application.
Signature*field type signature
Datefield type date
Date will be captured on form submission
How did you hear about this vacancy?*field type radio button
How did you hear about this vacancy?FacebookHandshakeIndeedJob FairNewspaperNorth Country NowOLASWebsiteWord of MouthOther

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