Dear Applicant: We look forward to receiving your application materials. Sincerely,

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1 Dear Applicant: Thank you for your interest in providing psychologist services for the Telluride School District. Enclosed is our District Application and information about the Telluride School District. Applications for administrative positions will be kept on file for 2 years. You must re-apply after this time. Only complete application files will be shown to the Hiring Committee for this position. In order to have a complete file you must submit: 1) Letter of Interest 2) Telluride School District s application 3) Current Professional Resume 4) A Copy of a current Colorado certificate/license, including all endorsements or a copy of current out-of-state license assuming ability to obtain a Colorado administrative license 5) Three to five recent letters of recommendation 6) Copy of college transcripts official transcripts will be required upon hire Questions regarding Colorado special services licenses should be directed to the Colorado Department of Education in Denver at , or to CDE s web site at ( We look forward to receiving your application materials. Sincerely, Nancy Scott-deCastro Human Resources Coordinator Telluride School District R-1 970/ ndecastro@telluride.k12.co.us

2 APPLICATION FOR PSYCHOLOGIST POSITION Date: Social Security #: Date of Birth*: Name: Last First Middle Mailing Address: P.O./Street City State Zip Telephone: (home) (cell) Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? Yes Proof of citizenship or immigration status will be required upon employment. Date Available for Employment: Do you have a valid Colorado Teaching Certificate? Yes Do you have a valid Colorado Special Services Certificate? Yes If yes, please attach copies to this application. If no, do you have a valid out-of-state Teaching Certificate? Yes Do you have a valid out-of-state Special Services Certificate? Yes If yes, please list the state, the type of certificates and all expiration dates. Do you speak a language other than English? *The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 65 years of age.

3 EDUCATION AND EMPLOYMENT Please attach your professional resumé and copies of your transcripts. Original transcripts will be required upon hire. REFERENCES: List any Superintendents or Supervisors who are familiar with your professional success. If you have had no administrative experience, give the names of your College Instructors with whom you have taken your major subjects. Please also include one personal reference that is neither a former employer nor a relative. Name Present Position Present Address Phone Number To be considered for employment, you must have a complete application packet consisting of: 1. Copies of transcripts (official transcripts will be required if employed). 2. Application with answers to Principal Application Supplement Questions. 3. Three recent letters of recommendation. 4. Copy of Colorado certificate/license or other state equivalent. Please note: If you wish your Application to remain active, it is your responsibility to contact the Personnel Office annually, or your Application will become inactive. Applicant s Statement I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not, and is not intended to be, a contract of employment. In the event of employment, I understand that false or misleading information given in my application, employment records, or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Telluride School District R-1. I authorize Telluride School District R-1 to make an investigation of my personal or employment history and authorize any former employer, person, firm, corporation, school, college, credit agency, or governmental agency to give the Telluride School District R-1 pertinent information they may have regarding me. This authorization shall remain in effect during the course of my employment with the school district for the purpose of verifying any information contained in my employment application. In consideration of the Telluride School District s review of this application, I release the school district and all providers of information from any liability as a result of furnishing and receiving this information. I understand that any offer of employment may be conditional upon the results of a post offer medical inquiry and/or medical examination, and the result of legally required background checks verifying felony or misdemeanor convictions. Signature of Applicant Date

4 PSYCHOLOGIST APPLICATION SUPPLEMENT Please complete the following questions, citing examples of past experiences. These should be no longer than one typed page each, double-spaced. 1. What experience do you have in the use of intelligence tests, personality assessments and behavior assessment/consultation? 2. What experience do you have in providing diagnostic evaluations to determine learning/emotional/behavioral needs of students? 3. Describe your background providing direct services to students through individual, small group, total class and family contacts. 4. Describe your experience providing consultative services to staff and parents regarding social, emotional, behavioral and educational needs. 5. Do you have experience providing mental health education? 6. Do you have experience in crisis intervention?

5 TELLURIDE SCHOOL DISTRICT R-1 Mission Statement: Through quality education, our students will achieve personal success. The Telluride R-1 School District in San Miguel County encompasses 326 square miles, including the Towns of Telluride, Mountain Village, Ophir, Placerville and the Fall Creek area. The district has three schools, an elementary, an intermediate and a middle/high school, which serve a total of approximately 700 students. The elementary school is a beautiful restoration of the original high school built in A addition opened in August 2000 expanding the facility by three classrooms, a new gymnasium and music room. A hallmark of the elementary school is its small class size, which allows for highly personalized instruction. The middle/high school opened in 1995 with state of the art technology for students and staff. Students enjoy the advantages of a comprehensive library, music rooms and computer labs. A large gymnasium offers two full-size practice courts and one competition court. The auxiliary gym has one of the largest climbing walls in Colorado. The facility is situated on a nearly 11-acre campus surrounded by playing fields and extensive landscaping. A five-member school board governs the District. There are 110 employees in the district including 5 administrators, 71 faculty members, 23 support personnel and 11 paraprofessionals. The majority of the faculty has Master s level degrees or above. Telluride Schools are known for exemplary programs and high student achievement. The Telluride scores on the Colorado Student Achievement Tests are consistently among the highest in the state. Outstanding programs and opportunities for students include advanced placement courses, specialized mentorships with community members, individual enrichment plans for students, extensive technology offerings and project based learning. The district has a partnership with the Telluride Ski and Golf Company to provide students with an outstanding Ski P.E. program each winter. There is also a comprehensive co-curricular program that includes a wide range of athletics and academic activities for students. The unique combination of innovative programs, high academic standards, dedicated staff and community support create an exceptional learning environment for Telluride s students. For further information about the Telluride Schools please visit our website at