Online Teaching Application

Online Teaching Application

First   Last 

Address 

Address Line 2 

City  State   Zip Code 

Phone (XXX-XXX-XXXX)   

Email 

CERTIFICATE DATA

Multiple Choice

Applied for but not recieved SC certification

BA

BA+18

MA

MA +30

Doctorate

Certificate Number 

Subjects certified to teach in SC 

Date Certificate Issued 

Expiration Date of Certificate 

Name Exactly as it Appears on Certificate 

Are you a member of SC Retirement Systems (SCRS)? Yes No

Have you withdrawn contributions from SCRS? Yes No

EDUCATIONAL TRAINING (Include name, address, dates attended, degree received, and area of study for each school.) 

GRADUATE TRAINING (Include name, address, dates attended, degree received, and area of study for each school.)

TEACHING EXPERIENCE (Include name of school, school system, address, dates, grades/subjects, and extra duties for each school.)

GENERAL INFORMATION

List your professional activities, honors, etc.

Military Service (if any) Branch 

Dates of service from 

To 

Are you under any legal or moral obligation to continue or to accept employment in any other school system?

State briefly your reasons for seeking a position in this school district.

Are you willing to come upon request for a non-obligated interview? Yes  No

AUTOBIOGRAPHY

In the space below, write an autobiographical essay.

REFERENCES

List References below

List five names of persons who have first-hand knowledge of your training, teaching ability, experience, or other qualifications for education service. Names of persons acquainted with you professionally are preferred. If you have not taught, list the names of persons who directed your teacher training activities in college.



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