IMAGINE SCHOOLS
AT SOUTH VERO

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Please fill in the below Employment Application
then click submit

Application for Employment

Please print legibly and complete all sections, indicating "n/a" if the information requested is not applicable.

Personal Data

*Name (last, first, middle):
*Social Security Number:
 Email Address
  
Present Address:
*Number and Street:
*City:
*State:
*Zip:
*How long have you resided there?
 
Previous Address:
Number and Street:
City:
State:
Zip:
How long have you resided there?
*Telephone Number:
*Are you over the age of 18?
  1. Yes
  2. No
If no, employment is subject to verification
that you are of minimum legal age:

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Employment Objective

*Position Desired:
*Salary Desired:
*Location:

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General Information

*How were you referred to us?
If you were referred by an employee,
please list their name and location:
*Have you ever been employed by Imagine Schools, Inc.,
Chancellor Beacon Academies, Inc.,
Chancellor Academies, Inc.,
Beacon Education Management
and/or JCR and Associates?
  1. Yes
  2. No
If yes, please list dates of employment.
From:
To:
*Have you ever been employed under
any name other than the one stated in this application?
  1. Yes
  2. No
If yes, please provide the other name(s):
*Do you have any relatives or friends employed
by Imagine Schools?
  1. Yes
  2. No
If yes, please provide their name, relationship
and location of employment:
*Are you presently employed?
  1. Yes
  2. No
If yes, what notice will be required?
*What date will you be available for employment?
*Have you ever been involuntary terminated,
not re-appointed or asked to resign from a previous job?
  1. Yes
  2. No
If yes, please explain:
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Certification

*Do you hold an Educator's Certificate?

  1. Yes

  2. No

If yes, please provide the following:
Certification Type 1:
Certificate Number 1:
Valid from 1:
Valid to 1:
Issuing State 1:
Subject, area or coverage 1:
Certification Type 2:
Certificate Number 2:
Valid from 2:
Valid to 2:
Issuing State 2:
Subject, area or coverage 2:
If you do not hold an Educator's Certificate,
are you eligible to receive one?
  1. Yes
  2. No
Please explain:
*Have you ever had an Educator's Certificate
suspended,revoked or not re-issued?
  1. Yes
  2. No
If yes, please explain:
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Education Record

*High School Address (City/State):
*High School Years Completed:
  1. 1
  2. 2
  3. 3
  4. 4
*High School Major Field of Study:
*High School Graduated:
  1. Yes
  2. No
*High School Degree:
College 1 Address (City/State):
College 1 Years Completed:
  1. 1
  2. 2
  3. 3
  4. 4
College 1 Major Field of Study:
College 1 Graduated:
  1. Yes
  2. No
College 1 Degree:
College 2 Address (City/State):
College 2 Years Completed:
  1. 1
  2. 2
  3. 3
  4. 4
College 2 Major Field of Study:
College 2 Graduated:
  1. Yes
  2. No
College 2 Degree:
Graduate School Address (City/State):
Graduate School Years Completed:
  1. 1
  2. 2
  3. 3
  4. 4
Graduate School Major Field of Study:
Graduate School Graduated:
  1. Yes
  2. No
Graduate School Degree:
Trade/Correspondence School Address (City/State):
Trade/Correspondence School Years Completed:
  1. 1
  2. 2
  3. 3
  4. 4
Trade/Correspondence School Major Field of Study:
Trade/Correspondence School Graduated:
  1. Yes
  2. No
Trade/Correspondence School Degree:
Other Address (City/State):
Other Years Completed:
  1. 1
  2. 2
  3. 3
  4. 4
Other Major Field of Study:
Other Graduated:
  1. Yes
  2. No
Other Degree:
*List academic honors, scholarships, and honorary fraternities:
*List hobbies and outside interests:
*Do you plan to continue your education?
  1. Yes
  2. No
If yes, please specifiy:

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Foreign Languages

Language 1:
Indicate degree of fluency 1: Read Write Speak
Language 2:
Indicate degree of fluency 2: Read Write Speak

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Business Skills

*Typing Speed:
*Word Processing:
*Shorthand:
*Dictaphone:
*Computer Hardware/Software:
Other Business Equipment:
*List any professional licenses you hold
other than teaching certificates:
*List any professional organizations you belong to:

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Military Service

Branch:
Highest Rank Attained:
Dates of Service:
Special Training:
Did you receive anything other than an honorable discharge?

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Driving Record

Answer these questions if driving is part of the duties and responsibilities of the job for which you are applying.
*Do you have a valid Driver's License?
  1. Yes
  2. No
*Issuing State:
*Driver's License Number:
*Expiration Date:
*Any restriction(s) on your license?
  1. Yes
  2. No
If yes, please explain:

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Criminal Record

Answering "yes" to these questions does not constitute an automatic bar of employment.
Only those crimes which are substantially related to the position you are seeking will be considered.
*Have you ever been convicted, pled no contest, been placed on probation, enrolled in a pre-trial diversion program, or had adjudication withheld in a criminal offense, felony, misdemeanor or otherwise?
  1. Yes
  2. No
If yes, please give dates and details for each instance:
*Do you have any criminal charges currently pending?
  1. Yes
  2. No
If yes, please explain:

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Employment History (complete in full - do not attach a resume)

Please list below all present and past employment since graduation, including at least three past employers, for the last ten years.
Dates of Employment 1:
Total Month 1:
Reason for Leaving 1:
Name of Employer 1:
Type of Business 1:
Address/City/State/Zip 1:
Phone 1:
Starting Position 1:
Supervisor's Name, Title & Phone 1:
Starting Salary 1:
Most Recent Position 1:
Supervisor's Name, Title & Phone 1:
Ending Salary 1:
May we contact? 1:
  1. Yes
  2. No
If not, why not? 1:
Give full description of responsibilities and duties 1:
Dates of Employment 2:
Total Month 2:
Reason for Leaving 2:
Name of Employer 2:
Type of Business 2:
Address/City/State/Zip 2:
Phone 2:
Starting Position 2:
Supervisor's Name, Title & Phone 2:
Starting Salary 2:
Most Recent Position 2:
Supervisor's Name, Title & Phone 2:
Ending Salary 2:
May we contact? 2:
  1. Yes
  2. No
If not, why not? 2:
Give full description of responsibilities and duties 2:
Dates of Employment 3:
Total Month 3:
Reason for Leaving 3:
Name of Employer 3:
Type of Business 3:
Address/City/State/Zip 3:
Phone 3:
Starting Position 3:
Supervisor's Name, Title & Phone 3:
Starting Salary 3:
Most Recent Position 3:
Supervisor's Name, Title & Phone 3:
Ending Salary 3:
May we contact? 3:
  1. Yes
  2. No
If not, why not? 3:
Give full description of responsibilities and duties 3:
Please explain any gaps in your employment history:

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Previous Experience

*Please describe any previous experience that you
have in the position for which you are applying,
or in any similar or related position:

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References

Please list three (3) individuals not related to you, whom you have known for at least one year, and who have observed your work performance (supervisors or employers, not co-workers).
Name 1:
Relationship 1:
Occupation 1:
Phone Number 1:
Years Known 1:
Name 2:
Relationship 2:
Occupation 2:
Phone Number 2:
Years Known 2:
Name 3:
Relationship 3:
Occupation 3:
Phone Number 3:
Years Known 3:
Name 4:
Relationship 4:
Occupation 4:
Phone Number 4:
Years Known 4:

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Emergency Contact

In case of accident or other emergency, whom should we contact?
*Name:
*Relationship:
*Home Phone:
*Cell Phone:
*Address (Number and Street):
*City:
*State:
*Zip:
*Place of Work (including address):
*Work Phone:

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We are an Equal Opportunity Employer

APPLICANT'S STATEMENT

By my signature below, I certify that all information that I have provided on this application, under separate cover and in any interview, as part of the application process, is true, complete and accurate. I understand that any false statements, omissions or misleading statements will be grounds to not hire me, and if discovered after employment, may subject me to dismissal.

I understand that if I am hired, my employment will be for no definite period, regardless of the period of payment of my wages. I further understand that I have the right to terminate my employment at any time, with or without notice or reason Company has authority to modify this relationship or make any agreement to the contrary. Any such modification or agreement must be in writing.

I understand that Imagine Schools, Inc. reserves the right to require me to submit to a drug test at any time and also reserves the right to require me to submit to an alcohol test and/or medical examination to the extent permitted by law. I further understand that the school may contact previous employers and I authorize those employers to disclose to the Company all records and other information pertinent to my employment with them. I release my previous employers from any liability as a result of their disclosure of information about me to the Company. I also authorize the Company to provide truthful information concerning my employment with it to my future prospective employers and I agree to hold it harmless for providing such information.

I understand the Company may obtain a consumer report or reports on me. I authorize Imagine Schools, Inc. and its representatives and agents to obtain such a report or reports for use in connection with my application for employment and for other employment-related reasons. If hired, this authorization shall remain on file and serve as ongoing authorization for procurement of employment-related consumer reports at any time during my employment. I understand the term "consumer report" includes, but is not limited to, credit checks, criminal background checks, department of motor vehicle reports, and investigative consumer reports.

By submitting this form, I certify that I have read and understand this statement.

DO NOT SUBMIT until you have read and understand this statement.


               

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NEWS FLASH

Notices

ISV Board Meeting:  07/19/11 at 2:00 PM


Imagine Schools at South Vero wins Class Size Amendment Appeal read story

Imagine Schools at South Vero
6000 4th St, Vero Beach, FL 32968
T: 772-567-2728     F: 772-410-0329
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