BRIDGER
PUBLIC SCHOOLS
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
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
• 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
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
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
To Whom It May
Concern:
I,
______________________________________, am seeking employment with the
I hereby release the
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
________________)
:
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
County
of _________________________________
My
commission expires ______________________
(seal)
BRIDGER
PUBLIC SCHOOLS
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
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?