Substitute Teacher Application. Thank you for considering a Substitute Teacher position with LISD!

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1 Laredo Independent School District Human Resources Department 1702 Houston St. Laredo, TX (956) Fax (956) visit: Required Documents: Substitute Teacher Application Thank you for considering a Substitute Teacher position with LISD! 1. Employment Application paper copy available at HR Office or it may be printed from our website at and submit it to the HR Office. 2. High School Diploma or GED a copy from an accredited institution. 3. Official Transcript if you hold a degree or have college hours, submit an official transcript from colleges/universities attended with degree posted or hours of coursework. 4. Substitute Teacher Certificate (see below) 5. Teaching Certificate if you hold a teaching certificate, submit a copy Substitute Teacher Certificate is offered at the Laredo Community College. For more information about the course, contact the Continuing Education Department at (956) There are three exemptions from the Substitute Teacher Certificate requirement: 1. Certified Teachers (retirees included) 2. Completed student teaching (verified through official college transcript) 3. Individuals who were initially hired as teachers and placed on a permit; and who have not completed the teacher certification requirements (verified through service record and/or SBEC) Upon completing requirements: Qualified applicants will be contacted for an interview upon an available vacancy. Your application will remain active for one year. Questions or concerns: Marta Walker, Human Resources Specialist or , ,

2 Employment Application for Substitute Teacher 1702 Houston Laredo, Texas LARED-08 An Equal Opportunity Employer It is the policy of the Laredo Independent School District not to discriminate on the basis of race, color, national origin, sex, handicap, or age in its employment practices as required by Title VI of the Civil Rights Act of 1964, as amended; Title IX of the Education Amendments of 1972; the Age Discrimination Act of 1975, as amended; and Section 504 of the Rehabilitation Act of 1973, as amended. Date of Application Social Security Number - - Name Last First Middle Initial Personal Data Current Address Street/Box City State Zip Code Work Phone Home Phone Cell Phone Other name that may appear on records (used only for reference checks) List the position(s) for which you are applying Position Data Date you can begin to work Have you been employed by Laredo I.S.D. in the past? No Yes If yes, please state name and campus/department: Have you ever been convicted of, plead guilty or no contest (nolo contendre) to, or received probation, suspension, or deferred adjudication for a felony? Yes No General Information Have you ever been convicted of offense involving moral turpitude (including, but not limited to, theft, rape, murder, assault, battery, DWI or DUI, swindling, and indecency with a minor)? If yes, please state where, when, and the nature of the offense Yes No (A felony conviction is not an automatic bar to employment. The district will consider the nature, date, and relationship between the offense and the position for which you are applying.) Are you eligible to work in the United States? Yes No

3 Check the highest level of education attained Not a high school graduate (Circle last grade complete) High School graduate Bachelor's Degree* Two or more years of college* Master's Degree* Associates Degree * Other training or education Education/Training *Official Transcript Required Valid licenses and certificates held, (include driver's license) CPR CDL TX Driver's License # Exp. Date First Aid HVAC Other Food Handlers Medical Assistant Name and location of schools attended Course of study and major/minor Diploma, degree, certificate or license held Year Graduated (college Only) List specific skills, software proficiency, and any machines or equipment you can operate. Include number of years of experience Work Experience Special Skills Number of years experience Number of years experience 3 6 Please provide a complete list of all positions you have held in the past 10 years. List the most recent first. Attach additional sheets if necessary (bus driver applicants see addendum). Attach resume if available. Employer Address Your Position/Title Dates employed-month/yr Reason for leaving and Phone References Please list references the district can contact regarding your work history. Please include all managers and supervisors who evaluated or supervised your performance at your last two employers. Full name of reference School district/ firm name Position/Title Mailing Address Area Code, Phone No. Home Work Home Work Home Work

4 Board of Trustees Board Member Jose R. Perez, Jr. Hector J. Garcia Dr. Cecilia M. Moreno Title President, District 7 Vice President, District 6 Secretary, District 5 Spouse Idalia (Mata) Samuel Moreno General Information Jose A. Valdez Jesus Martinez John Amaya George M. Beckelhymer Trustee, District 1 Trustee, District 2 Trustee, District 3 Trustee, District 4 Romana (Castillo) Karla (Narvaez) Priscilla (Martinez) I, hereby attest or affirm that I am / I am not related to any member of the Name of Applicant Circle One Board of Trustees of the Laredo Independent School District, within the third degree of consanguinity (blood relation) or by second degree of affinity (marriage). If applicable, please indicate to whom you are related: Name of Board Member Relationship to applicant I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentation, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing the same to you. I (name of applicant) have applied for employment with the Laredo Independent School District. I hereby give the district permission to make inquires of references and former employers concerning my performances and general character, This permission form may be attached to requests for information I authorize the party receiving this form to give full information as may be requested by the Laredo Independent School District. I further agree that the information requested will not become a part of my personnel file if I am employed by the district and I agree that the information will not be disclosed to me but will be treated as confidential by the district and I waive any right to see this information. Verification I understand that the district is authorized by Texas Education Code ξ to obtain criminal history record information on applicants the district intends to employ. Signature Date This application becomes the property of the district. The district reserves the right to accept or reject it. This application shall be considered active for one year. If you have not received a response during this time period, you may reapply. Thank you for your interest in the Laredo Independent School District. Please return this application and requested information/ material to: Laredo Independent School District (956) Human Resources Department (956) (FAX) 1702 Houston St. (2nd floor) LARED-08 Laredo, TX

5 CRIMINAL HISTORY RECORD INFORMATION ADDENDUM This is to notify you that a Background Investigation will be conducted on you for employment purposes or practicum/observation purposes. By signing the release below, you hereby authorize the Laredo Independent School District to contact any and all corporations, former employers, educational institutions, law enforcement agencies, city, state, county, and federal courts, military services to release information about your employment, education, driving record (if applicable), criminal record and general public record history to the Laredo Independent School District. You agree to release from all liability all persons, companies, schools supplying such information. You agree to indemnify the Laredo Independent School District against any liability which may result from making such requests. This release shall remain in effect for the length of your employment or practicum with the Laredo Independent School District. You understand that you may have a right to request additional disclosures regarding the nature and scope of the investigation. You swear or affirm to the best of your knowledge that all information you have provided is accurate, true and correct and that you fully understand the terms of this release. Note: The Laredo Independent School District requests your date of birth solely for the purpose of verifying certain records that may be produced in connection with the background investigations. It is the policy of the Laredo Independent School District to provide equal opportunity to persons regardless of race, religion, age, gender, disability or any other classification in accordance with federal, state and local statures, regulations and ordinances. BACKGROUND INVESTIGATION QUESTIONNAIRE: PLEASE PRINT FULL LEGAL NAME NO ABBREVIATIONS Name: Home Address: (Last) (First) (Middle) (Street) (Apt./Lot #) Social Security Number: (City) (State) (Zip) Date of Birth: Driver's License No.: or I.D. & No.: State issuing license: State issuing I.D.: Other Name(s): (maiden, other married names, include year of name change) Telephone Number: home ( ) cell ( ) PREVIOUS RESIDENTIAL ADDRESSES: (Previous seven years) Former Address Street City State Zip Code Years Resided Street City State Zip Code Years Resided Street City State Zip Code Years Resided (Continue on a separate page if necessary) Signature: Date:

6 DPS Computerized Criminal History (CCH) Verification (AGENCY COPY) I,, have been notified that a computerized criminal APPLICANT or EMPLOYEE NAME (Please print) history (CCH) verification check will be performed by accessing the Texas Department of Public Safety Secure Website and will be based on name and DOB information I supply. Because the name based information is not an exact search and only fingerprint record searches represent true identification to criminal history, the organization (as listed below) conducting the criminal history check is not allowed to discuss any information obtained using this method, therefore the agency may offer the opportunity to have a fingerprint search performed to clear any misidentification based on the name search, if the search provides a criminal report I know could not be mine. For the fingerprinting process I will be required to submit a full and complete set of my fingerprints for analysis through the Texas Department of Public Safety AFIS (automated fingerprint identification system). I have been made aware that in order to complete this process I must have the correct fingerprinting (FAST) form from this agency, make an online appointment, submit a full and complete set of my fingerprints, and pay a fee of $9.95 to the fingerprinting services company, L1Enrollment Services. Once this process is completed and the agency receives the data from DPS, the information on my fingerprint criminal history record may be discussed with me. (This copy must remain on file by your agency. Required for future DPS Audits) Signature of Applicant or Employee Date Agency Name (Please print) Agency Representative Name (Please print) Signature of Agency Representative Date Please: Check and Initial each Applicable Space CCH Report Printed: YES NO initial Purpose of CCH: Hire Not Hired initial Date Printed: initial Destroyed Date: initial Retain in your files

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