Employment Application Non Instructional - Atlanta Neighborhood Charter School

Position Applied For*

Personal Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Education

List below all high schools, colleges or universities that you have attended. Begin with most recent:*

Click the plus (+) sign to add entries.

HIgh School / College / University	Dates Attended	Major, if applicable	Degree / Diploma	Date of Degrees / Diploma

Relevant Work Experience

Begin with the most recent:*

Click the plus (+) sign to add entries.

Employer (include address)	Dates	Supervisor	Position Held	Reason for Leaving

Other Work Experience

Begin with the most recent:

Click the plus (+) sign to add entries.

Employer (include address)	Dates	Supervisor	Position Held	Reason for Leaving

General Information

Were you ever in the armed forces?*

Yes
No

Were you honorably discharged?

Yes
No

Are you a citizen of the United States?*

Yes
No

If no, do you have a legal right to work in this country?

Yes
No

Attach copy of ALIEN REGISTRATION CARD

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Contracts / Licensure and Criminal Record

Answer each question yes or no. You must attach a copy of the court disposition or judge's sentencing order if you answer “yes” to questions 1 or 2. You must attach supporting documentation and a written explanation if you answered “yes” to any of the questions below. THIS SECTION MUST BE COMPLETE FOR AN APPLICATION TO BE CONSIDERED.

1. Have you been convicted of or pled nolo contendre on any of the following, including, but not limited to: murder, sexual or physical assault, rape, child molestation, kidnapping, manslaughter, extortion, sexual misconduct with a minor, indecent liberties, incest, unlawful imprisonment, child abuse or neglect, abduction for immoral purposes, failure to secure medical attention for an injured child, pandering, crimes against nature involving children, malicious harassment, patronizing a juvenile prostitute, child abandonment, violation of a child abuse protective order, obscenity offenses, possession or distribution of drugs, arson, use of a firearm in the commission of a felony, child buying or selling, prostitution, felony indecent exposure, larceny, embezzlement or any of these crimes as may be renamed in the future?*

Yes
No

Upload supporting documentation.

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

2. Have you been convicted of any felony or misdemeanor other than those listed above in question 5 or pled nolo contendre, or are you now under investigation for any such offense, other than a minor traffic offense? For the purpose of this application DUI/ DWIs must be reported.*

Yes
No

Upload supporting documentation.

Allowed file types: jpg, gif, png, pdf, zip, doc, docx

Accepted file types: jpg, gif, png, pdf, zip, doc, docx, Max. file size: 64 MB.

3. Have you ever resigned or been discharged from any position, including the Armed Forces while under suspicion of having engaged in criminal, immoral or unprofessional conduct, or are you now under investigation for any such charge?*

Yes
No

4. Have you ever surrendered your teaching or administrative certificate/license/permit, or had one denied, revoked or suspended or is any investigation or adverse action now pending against you?*

Yes
No

5. Have you ever had any disciplinary action taken against you by a previous employer, including written reprimand, suspension, demotion, non-‐renewal, termination or any other form of disciplinary action?*

Yes
No

Investigation Consent & Release From Liability Agreement

Making a materially false statement regarding these offenses is a misdemeanor. Such a conviction shall be grounds for the Georgia Professional Standards Commission to revoke your certificate. An applicant who is unable to complete the above certification will not be considered for employment with the Atlanta Neighborhood Charter School.

Please check each of the following:*

I authorize the Atlanta Neighborhood Charter School (ANCS) to make an investigation of any personal, educational, vocational or employment history. I further authorize any former employer, person, firm, corporation, educational or vocational institution, or government to provide the ANCS with information they have regarding my performance, character, and general reputation. I discharge ANCS and those who provide information from any liability as a result of furnishing this information.
I have identified that all statements and data provided are true and correct to the best of my knowledge. I agree that falsification will constitute disqualification of my application or dismissal from employment from the Atlanta Neighborhood Charter School.
I understand that any offer of employment is contingent upon ANCS Governing Board approval and an acceptable outcome of criminal records check. It is further understood that the criminal records check will be conducted at my expense.

Electronic Signature*

By selecting the "I Accept" button, you are signing this Application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Application.

I Accept

Resume and Letter

Upload File(s)*

Please upload a current résumé. Maximum file size is 10MB. Allowed file types: jpg, gif, png, pdf, zip.

Accepted file types: jpg, gif, png, pdf, zip, doc, docx, Max. file size: 10 MB.

Upload File(s)*

Please upload a letter of interest. Maximum file size is 10MB. Allowed file types: jpg, gif, png, pdf, zip.

Accepted file types: jpg, gif, png, pdf, zip, doc, docx, Max. file size: 10 MB.

Email

This field is for validation purposes and should be left unchanged.