Baker Schools 5J

Baker Schools 5J

Classified Application Form Updated

Personal Information
Position For Which You Are Applying:
Personal Information
Date of Application

Month Day Year
Date
Full Name *

First Name Middle Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Alternate Phone Number

Area Code Phone Number
Email
example@example.com

Educational Experience
Educational Experience
High School Attended (Name, City, State, and Diploma Earned, or Dates Attended). *
College/University Attended (Name, City, State, and Degree Earned, and Dates Attended).

Employment History
Employment History
This section must include all information requested or it will not be considered. List your previous jobs held (at least three) without omission. Enter current or most recent first and include work related to the position for which you are applying. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.
Name of Employer
Dates Employed

Month Day Year
Date
To

Month Day Year
Date
Duties Performed

0/100
Supervisor's Name
Supervisor's Phone Number

Area Code Phone Number
Name of Employer
Dates Employed

Month Day Year
Date
To

Month Day Year
Date
Duties Performed

0/100
Supervisor's Name
Supervisor's Phone Number

Area Code Phone Number
Name of Employer
Dates Employed

Month Day Year
Date
To

Month Day Year
Date
Duties Performed

0/100
Supervisor's Name

First Name Last Name
Supervisor's Phone Number

Area Code Phone Number
Name of Employer
Dates Employed

Month Day Year
Date
To

Month Day Year
Date
Duties Performed

0/100
Supervisor's Name

First Name Last Name
Supervisor's Phone Number

Area Code Phone Number
Summarize other work experience (including military or volunteer) Related to Position Applied For:

0/500

References
References
Name of Reference # 1

First Name Last Name
Reference #1 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Reference #1 Phone Number

Area Code Phone Number
Name of Reference # 2

First Name Last Name
Reference #2 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Reference #2 Phone Number

Area Code Phone Number
Name of Reference # 3

First Name Last Name
Reference #3 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Reference #3 Phone Number

Area Code Phone Number

Document Upload
Current Resume (PDF) *

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Current Letter of Interest or Cover Letter *

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Current Letter of reference 1

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Current Letter of reference 2

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Current Letter of reference 3

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Veterans Preference
Military Experience
Are you a "Veteran" as defined under Oregon law (ORS 408.225(f))?
Are you a "Disabled Veteran" as defined under Oregon law (ORS 408.225(c))?
If Yes to either of the above two questions please upload a copy of the certificate or Discharge from Active Duty (DD Form 214 or 215). PDF format preferred

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If Yes to being a "Disabled Veteran" please upload a copy of theVeterans Disability Preference Letter. PDF format preferred

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Health Status
Health Status
Can you perform the essential job functions described in the attached job description?

Effort will be made to reasonably accommodate job-related mental or physical handicaps.
Select Yes or No to Above Question

Availability
Availability
Can you begin work for Baker School District 5J:

Now

Consent and Authorization
Consent and Authorization
Baker School District is an equal opportunity educator and employer and does not discriminate on the grounds of race, color, religion, sex, sexual orientation, national origin, marital status, age, veterans’ status, genetic information, disability, culture and/or financial status.

I understand that any omissions on this application may prevent my application from being evaluated. I verify that all information on this employment application is true and complete. I understand that any misrepresentation, falsification or omission on this application or on other documents submitted to the Baker School District 5J will be sufficient cause for this application not to be considered by the school district, or for discharge if I have been employed.
Authorization to Obtain and Release Information: I authorize Baker School District 5J for which I have completed an employment application to check my references, to obtain information from my prior employers and educational institutions, and to take other actions to investigate any information provided in my employment application, and to obtain information relevant to evaluating my qualifications and fitness for the position, which I have applied. I authorize my listed references, past employers and educational institutions, and anyone else who has information about my work history, education qualification or fitness, to provide such information to Baker School District 5J. I release the Baker School District 5J and all persons providing information to Baker School District 5J from any liability whatsoever for obtaining and providing that information, regardless of the results.
*By typing in your full first and last name you are agreeing to signing this document digitally.
Today's Date

Month Day Year
Date

Criminal History
Criminal History Records Check/Fingerprinting Consent Form
I understand that law and Baker School District 5J Board Policy require criminal history records check and fingerprinting. Employment shall be offered prior to fingerprint collection. Upon receipt of notification by the Oregon Department of Education that I have been convicted or made a false statement as to conviction of any crimes prohibiting employment or contract status with Baker School District 5J, the Superintendent or his/her designee shall immediately terminate my employment or contract. I understand that if I am terminated I may appeal action taken by the Oregon Department of Education as result of such check in accordance with procedures established by law. Should I refuse to consent to a criminal history records check, or refuse to fingerprinted, I shall immediately be terminated from employment or contract status by the Superintendent or his/her designee.
*By typing in your full first and last name you are agreeing to signing this document digitally.
Today's Date

Month Day Year
Date

Pre-Employment Drug Testing
Pre-Emplyment Drug Testing
I understand that pursuant to Baker School District 5J Policy, that if I am selected for employment, I must satisfactorily complete screening tests for illegal drug use prior to the District presenting a final offer of employment. All offers of employment are contingent on my successfully passing the District’s pre -employment drug screening test.
*By typing in your full first and last name you are agreeing to signing this document digitally.
Today's Date

Month Day Year
Date

Submission
I am not a robot *
Should be Empty: