BRIDGER PUBLIC SCHOOLS

PO BOX 467

BRIDGER, MT 59014

406-662-3533

406-662-3520 fax

 

AN EQUAL OPPORTUNITY EMPLOYER THAT ENCOURAGES APPLICATIONS FROM ALL PERSONS REGARDLESS OF RACE, RELIGION, SEX, AGE, NATIONAL ORIGIN, OR DISABILITY.

 

 

Application for Superintendent

 

All statements and information provided within this application and its attachments, if any, are true and complete.  I understand that omission or misrepresentation of material fact may result in refusal of or separation from employment.

 

________________________________________________________________________

Applicant Signature                                                                          Date

 

Name:  _________________________________________________________________

              Last                                                             First                                                                      Middle

 

Address:  _______________________________________________________________

                       Street or Box Number                                                        City                            ST                      Zip

 

Telephone: _____________________________________________________________

                             Home                                                               Cell                                              Work

 

Social Security Number: ______________________ Date of Application: ____________

                                                                                                                                      Valid for one year after this date

 

Do you hold a valid Montana Certificate? _______ Folio # ______ Class Level ________

Grade level:  K-8 _____ 5-12 _____ 7-12 _____ K-12 ______ Exp. Date ___________

Major Area(s) of Endorsements: _____________________________________________

Minor Area(s) of Endorsements: _____________________________________________

 

 

 

            Instructions and Information

 

Please complete all pages of the application fully.  Furnishing information on the application is mandatory unless otherwise stated.

 

• In addition to the completed and signed form, please provide the following additional information:

 

            1.  Cover letter specifying your qualities for the position.

 

            2.  Professional resume which includes academic preparation, experience and other specifically related qualifications.

 

            3.  Copies of transcripts of all college or university credits to date (official transcripts required upon hire).

 

            4.  Letters of recommendation (minimum of three), college placement file or portfolio.

 

            5.  Evidence of Montana Certification/Licensure

 

• An application may be submitted in person, by mail, or by fax to the attention of Betty Sweet, District Clerk.  Applications must be received by the final filing date.  Postmarks are not accepted.

 

• Photocopies may be submitted in place of an original application.

 

• Applications and supporting materials will not be returned.

 

• Bridger School District No. 2 does not reactivate files for future applications.

 

• Finalist candidates will be contacted by the district.

 

Please answer the following questions:

 

1.  Do you have the legal right to work in the United States?

 

2.  Are you able with or without reasonable accommodation to perform the functions of the job for which you are applying?

 

3.  Have you ever been released or discharged from employment or resigned to avoid such release or discharge?  If yes, please explain; include date of discharge or resignation and reason for discharge or resignation:

 

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

 

 I have not pled guilty to or have been convicted of any violation of criminal law, including criminal convictions resulting from a deferred sentence or a plea of nolo contendere (minor traffic offenses excepted.

 I have pled 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.)

 

            Additional Application Information

 

Please include any additional Pertinent Information, Qualification, Certificates, etc.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

(Please list current information for at least three and no more than five references below)

 

     Name                      Title                  Address                                    Phone (work & home)

 

1.

 

2.

 

3.

 

4.

 

5.

 

 

Education History

(List from most recent to least recent attendance)

 

     University/College             Location                 Subject           Degree                 Year              GPA

 

1.

 

2.

 

3.

 

4.

 

5.

 

Credits completed beyond attainment of teaching certification (note whether semester or quarter credits):  Undergraduate ________________________     Graduate  ______________________

 

            Employment Record

List your present or most recent employer first.  Describe your employment history, accounting for all time during at least the past 15 years.  You may include volunteer and paid experience.  DO NOT substitute a resume.  You may attach additional information.

 

Do you wish to be notified before we contact your current or previous employers? Yes ____ No ____

 

Employer: ________________________________________ Your job title: ___________________

 

Address: __________________________________________________________________________

 

Immediate supervisor and title: ________________________________________________________

 

Telephone: ____________________________ Employment dates:  From __________ To: ________

 

Job Duties (brief statement – be sure to list all duties related to this position):

 

 

 

 

 

Reason for leaving: __________________________________________ Salary: $_______________

 

 

Employer: ________________________________________ Your job title: ___________________

 

Address: __________________________________________________________________________

 

Immediate supervisor and title: ________________________________________________________

 

Telephone: ____________________________ Employment dates:  From __________ To: ________

 

Job Duties (brief statement – be sure to list all duties related to this position):

 

 

 

 

 

Reason for leaving: __________________________________________ Salary: $_______________

 

 

Employer: ________________________________________ Your job title: ___________________

 

Address: __________________________________________________________________________

 

Immediate supervisor and title: ________________________________________________________

 

Telephone: ____________________________ Employment dates:  From __________ To: ________

 

Job Duties (brief statement – be sure to list all duties related to this position):

 

 

 

Reason for leaving: _________________________________________Salary: $_________________

 

            Statements and Acknowledgement

 

Equal Opportunity Employer

Bridger Public Schools No. 2 prohibits discrimination against or harassment of any person employed by or seeking employment with the school district because of race, creed, religion, color, political affiliation or national origin or because of age, physical or mental disability, marital status, or sex distinction.  People of disability may request reasonable accommodation in the hiring process by contacting the school district personnel office.

 

Proof of Employability, TB Test

Any applicant chosen for employment must be able to produce a social security card, driver’s license, or some other acceptable form of verification of employment eligibility in the United States pursuant to Form I-9 of the Department of Justice.

 

Similarly, a selected applicant must provide verification of having received a tuberculin (TB) test within the past year.  Verification must include the date of the test, the results of the test, and the signature of the person who conducted the test.  It is policy to require verification of a TB test from any candidate chosen for employment and to require submitted documentation for the results of a tuberculin (TB) test within seven (7) days of employment.

 

Authorization to Release Employment Records

If employed by a school district, the applicant authorizes the school district to supply his/her employment record at the school district’s sole discretion, in whole or part, to any prospective employer, government agency, or other party, when the school district’s interest is deemed appropriate.  Please see Authorization to Release Information on subsequent page.

 

Drug Free/Tobacco Free Policies

Bridger Public Schools #2 is a drug free, tobacco free school and, as such, require all employees to adhere to specific drug free, tobacco free policies.

 

Background Check/Fingerprinting

Successful candidates will be required to submit to a Federal background check including fingerprinting.  Employment is contingent upon satisfactory results of the Federal background check.

 

Acknowledgment

I understand that no offer of benefits, such as, but not limited to, insurance, vacation, or salary rate, is

Final until it has been reviewed by the Personnel/Human Resources Department, and fully approved by the Board of Trustees or designated authorized representative.  Further, I have read and understand the above policies of employment.  If employed by Bridger Public Schools #2, I agree to abide by these policies of employment.

 

 

 

_________________________________________________________________________________

Applicant Signature                                                                       Date

 

 

 

 

 

 

 

 

            Authorization to Release Information

 

BRIDGER PUBLIC SCHOOLS DISTRICT 2

 Bridger, Montana

 

To Whom It May Concern:

 

            I, ______________________________________, am seeking employment with the Bridger School District.  I acknowledge that a complete investigation into my background is necessary to protect the safety and welfare of the children in the Bridger School District.  I hereby expressly and voluntarily give the Bridger School 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 of a confidential or privileged nature, including confidential criminal justice information as defined in Section 44-5-103(3), MCA, to the staff of the Bridger School District and its agents.  I understand that the Fairview School 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 Bridger School District and any organization, company, institution, or person furnishing information to the District and its agents as expressly authorized above, from any liability for damage, which may result from any dissemination of the information requested, subject to the provisions of Title 44, Chapter 5, Part 3, MCA.

            This document is effective until revoked in writing by me.

 

 

__________________________________________                           _________________________

Signature                                                                                         Date

 

Print Full Name: __________________________________________________________________

 

Print Full Address:  _________________________________________________________________

                                                                                    City                        ST                          Zip

 

Birth Date: ____________________________  Social Security Number: _______________________

 

STATE OF ________________)

 

: SS. County of ___________________)

 

            On this _________day of ______________________________, 20___, before me, a notary public of the State of _____________, personally appeared _______________________________,

known to me to be the person named in the foregoing Release, and acknowledged to me that he/she executed the same as his/her free act and deed, for the uses and purposes therein mentioned.

 

            IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal the day and year in this certificate first above written.

 

                                                                        __________________________________________

                                                                        Notary Public, State of Montana

                                                                        County of _________________________________

                                                                        My commission expires ______________________

                 (seal)

 

 

BRIDGER PUBLIC SCHOOLS

PO BOX 467

BRIDGER, MT 59014

406-662-3533

406-662-3520 fax

 

Superintendent’s Supplementary Application Insert

 

 

Please respond to the following questions:

 

1.  Why do you want to be employed as an administrator/principal at Bridger School?  What special qualities do you have that merit an interview?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.  Describe in you own words the priorities of a Superintendent.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

            Supplementary Application Insert Cont.

 

3.  What is your vision for implementation of a technology plan?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.  How would you promote/achieve parental and community involvement/support with the Bridger school system?