Name *

First Name

Last Name

Background Check Info *

Were you ever convicted of a criminal offense?

Yes

No

*

Are you currently under charges for a criminal offense?

Yes

No

*

Have you ever forfeited bond or collateral in connection with a criminal offense?

Yes

No

*

Have you ever been professionally disciplined in any state? (as in, an annulment, revocation or suspension of your teaching certification, qualification to instruct minors, or having received a letter of reprimand from an agency, board, or commission)

Yes

No

*

Are you subject to any visa or immigration status, which would prevent lawful emplyment

Yes

No

Which courses have you taught, or are interested in teaching? *

Algebra I

Algebra II

Geometry

Pre-Cal

Calculus AP

BIology

Chemistry

Physics

English IV

AP English Language & Comp

US History

World History

Psychology

Sociology

Business

Engineering

Marine Science

Art