Teaching Application Checklist □ 1) Letter of Interest/Application□ 2) District Application (Upon hiring, background check will be required.)□ 3) Credentials or three current letters of recommendation.□ 4) Transcripts (Copies are acceptable. Upon hiring, certified copies will be required.)□ 5) Copy of Montana Certified Teaching Endorsement or equivalent credentials.□ 6) Resume

Dear Candidate,

Please use this sheet as a checklist to ensure you have all the necessary documents for a complete application.

You can mail or email your complete application to:

Kara Triplett-SuperintendentLambert Public School PO Box 260 Lambert, MT 59243 ktriplett@lambertschool.net

We look forward to your application. If you have any questions, please don’t hesitate to call. 406-774-3333 ext.1103Regards,

Kara Triplett

Superintendent

TEACHER APPLICATION FORM

LAMBERT PUBLIC SCHOOLS

P.O. BOX 260

LAMBERT MT. 59243 Phone: 406-774-3333

Website http://lps.schooolwires.net

Date:_________________________

Name ______________________________________________________ Social Security #_____________________

First Middle Last

Present Address______________________________________________ Phone______________________________

Street City State Zip

Permanent Address___________________________________________ Phone______________________________

Street City State Zip

Montana Certificate # ________________ Class__________ Level ___________ Endorsements __________________

If you do not have a MT certificate, have you passed the NTE (National Teacher’s Examination)? ___________________

When available _____________________

Activities you can direct or coach: ______________________________________________________________________

EDUCATION AND PROFESSIONAL TRAINING (List most recent first) Undergraduate Graduate

Name of Institution Location Major/Minor Degree Degree

WORK EXPERIENCE (List most recent first:) Dates

Name & Location of School/Employer Explanation of Work From-To

Reason(s) for leaving last/present teaching position ______________________________________________________________________________

STUDENT TEACHING EXPERIENCE

Name & Location of School Cooperating Teacher Subjects Dates

HONORS, AWARDS, ORGANIZATIONS

List any honors received; organization memberships, etc. _________________________________________________________________________

REFERENCES

Give at least three references, including Superintendents, Principals, and Employers under whom you have worked recently and who have first-

hand knowledge of your qualifications.

Name Official Position Address Phone Number

Do you have the legal right to work in the United States? Yes No

Have you ever been denied a teaching certificate/license or had your teaching certificate/license or teaching certificate/license suspended or

discharge? Yes No

Have you ever been released or discharged from employment or resigned to avoid such release or discharge? Yes No

If yes, please explain, include date of discharge or resignation and reason for discharge or resignation: ____________________________________

I hereby certify that (check the applicable box and provide the information requested:)

___ I have not pleaded guilty to or have been convicted of any violation of criminal law, including criminal convictions resulting from deferred

sentence or a plea of nolo contendere/no contest (minor traffic offenses excepted)

___ I have pleaded guilty to or have been convicted of at least one violation of criminal law. Please attach and sign a complete description of the

circumstances surrounding such conviction. (This may not necessarily disqualify a person from consideration for employment.

I certify that the above information is true and complete to the best of my knowledge and I am aware that any misrepresentation shall be

considered as sufficient cause of dismissal.

________________________________

Date

____________________________________________

Applicant’s Signature

Send Material To: Kara TriplettLambert Public Schools

PO Box 260

Lambert, MT 59243

Or submit by email: ǎbeddow@lambertschool.net LJƘΦ 406-774-3333

SUMMARY QUESTIONS

1. Please give your philosophy of education and classroom control.

2. Describe some of your assets that will help you in your specific area of employment.

3. Why do you want this job?

NOTICE TO APPLICANTS

RE: Criminal Background Check

In an attempt to ensure the safety of the children of Lambert Schools, the Trustees may require a criminal background check. In

order to be considered for employment, all applicants must sign below signifying their knowledge and approval for the district to

request and conduct such a review.

_______________________________________________ __________________________

Applicant Signature Date

OTHER INFORMATION

Please provide all information requested. It is the applicant’s responsibility to request official and up-to-date transcripts and

credentials from his/her college or university. All transcripts are furnished at the applicant’s expense. A salary schedule prevails in

this district; the salary being dependent upon training and experience. Verification of previous experience must be furnished; if

elected; forms for this purpose will be furnished.

AUTHORIZATION TO RELEASE INFORMATION

I, ______________________________________, am seeking employment with the Lambert School District. I acknowledge that

complete investigation into my background is necessary to protect the safety and welfare of the children of the District. I hereby

expressly and voluntarily give the District the right to make a thorough investigation of my past employment, education, and

activities. I specifically authorize the release of any and all information as defined in section 44-5-103 and 41-3-205 (3) (0) MCA, to

the staff of the District and its agents. I understand that the District reserves the right to use any lawful method of investigation that,

in its sole discretion, it deems reasonable and necessary.

I hereby release the District and any organization, company, institution, or person furnishing information to the District and its

agents as expressly stated above, from any liability for damage which may result from any dissemination of the information

requested above subject to the provision of Title 44, Chapter 5, Part 3, and Title 41, Chapter 3, MCA.

This document is effective until revoked in writing by me.

Print FULL NAME: ______________________________________________

Print FULL ADDRESS: ______________________________________________

______________________________________________

ANY OTHER NAMES UNDER WHICH YOU HAVE BEEN EMPLOYED:

______________________________________________

Print BIRTHDATE: ______________________________________________

Print SOCIAL SECURITY NUMBER: _________________________________________

Signature: _______________________________________ Date: ________________

STATE OF ___________________ COUNTY OF __________________________

On this ______ day of ________________, ________, before me a notary public of the State of ______________________,

personally appeared __________________________________, known to be the person named in the foregoing release, and

acknowledged to me that _______executed the same as __________ free act and deed, for the purposes therein mentioned.

IN WITNESS THEREOF, I hereunto set my hand and affixed my notorial seal the day and year in this certificate first above

written.

_____________________________________

Notary Public Signature

State of ______________________________

County of _____________________________

My commission expires: _________________

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Appendix A

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