(Check a Box) & I will provide necessary documentation to validate that I am
Have you ever worked for this cooperative before?
Are you available to work:
Please indicate your source of referral:
United States Military Service
Do you have United States Military Experience?
Enter your last four employers, starting with the most current one.
Are there any other places you have worked in addition to those listed above?
Include three professional references who supervised your previous work (principals, supervisors, superintendents).
Please complete the following section if applying for a licensed position.
Illinois State Board of Education Professional Educator License (PEL), if applicable
Illinois Department of Financial and Professional Regulation License, if applicable
National Provider Identifier, if applicable
THIS SECTION MUST BE COMPLETED AS PART OF THE APPLICATION PROCESS. PLEASE MAKE CERTAIN THAT YOU ANSWER ALL OF THE QUESTIONS TRUTHFULLY. OMISSION OR FALSIFICATION OF ANY CRIMINAL INFORMATION WILL BE GROUNDS FOR IMMEDIATE DISMISSAL
Have you ever been convicted of an offense other than a minor traffic violation?
NOTE: An applicant for employment is not obligated to disclose sealed or expunged records of conviction or arrest. You are also not obligated to disclose expunged juvenile records of adjudication or arrest.
Have you ever been convicted of, had adjudication withheld, pled no contest to, or entered a pretrial intervention program for a misdemeanor or felony criminal charge?
Have you ever been the subject of an indicated report by DCFS or similar state agency?
Have you ever been suspended without pay, or dismissed from employment, or resigned while an investigation was in progress for possible disciplinary action?
Acknowledgement & E-Signature
By signing below, I understand that the information provided is true and correct, and that any misstatements or omission of material facts in the application or the hiring process may result in discontinuing of the hiring process or termination of employment, no matter when discovered. I agree that the district shall not be held liable in any respect if my employment is terminated because of false statements, answers or omissions made by me in this application.
I authorize the school district to analyze the truthfulness of all statements made on this application, complete reference checks from my current and former employers, and others that may provide information regarding my education and experiences. I also authorize a criminal background, sex offender, and other checks required by Federal and State government and the school code. I acknowledge that consideration for employment is contingent on the results of these background check(s). In addition, I give my consent for all contacted persons including current and former employers to provide information concerning this application, and I release each such person from liability for providing information to the school district.
I hereby attest that all statements made by me above are true to the best of my knowledge, and I agree to the terms noted above.