COMMUNITY SCHOOL TUTOR EVENING
: Job Details :

QUALIFICATIONS -* MUST HAVE VALID ILLINOIS TEACHING CERTIFICATE* REGISTERED IN PEORIA COUNTY* MUST PASS A PRE-EMPLOYMENT PHYSICAL, AND DRUG/ALCOHOL SCREENING* MUST PASS A CRIMINAL BACKGROUND CHECK Conditions of Employment

I acknowledge that I am eligible to work legally in the United States and can, upon employment, submit verification of my legal right to work in the United States.

I hereby authorize Peoria School District 150 to forward my name to the Illinois Department of State Police for the purpose of conducting a fingerprint-based criminal history records check as required by Section 10-21.9 of the School Code and agree to execute any forms and submit to fingerprinting as required for such purpose. I understand that the Illinois Department of State Police will conduct a fingerprint-based criminal history records check to ascertain whether I have been convicted of any of the enumerated criminal or drug offenses in subsection (c) of Section 10-21.9 of the School Code or have been convicted, within 7 years of the application for employment with Peoria School District 150, of any other felony under the laws of Illinois or of any offense committed or attempted in any other state or against the laws of the United States that, if committed or attempted in Illinois, would have been punishable as a felony under the laws of Illinois. I understand that Peoria School District 150 may further conduct a check for any indicated reports of child abuse pursuant to the Abused and Neglected Child Reporting Act, 325 ILCS 5/1 et seq. I further understand that Peoria School District 150 will perform a check of the Statewide Sex Offender Database and the Statewide Child Murderer and Violent Offender Against Youth Database as required by Section 10-21.9 of the School Code.

Are you licensed and/or certified or have a pending Illinois certification for the positions for which you are applying?

Do you understand that any false or misleading information in this application (or any omissions of information) may be full and sufficient grounds to deny employment, withdraw any offer of employment, or, having been employed, may be immediate cause for dismissal?

I authorize all current and former employers and other persons to give any information they have regarding my employment with them. Further, I release and hold harmless the officers, board members, agents, employees, and directors of each of my current and/or past employers and Peoria Public Schools District 150, its officers, board members, agents, employees, and directors from any liability arising from disclosures of any such information including any verbal appraisals of my past performance.

I hereby certify that the facts set forth in this employment application are true and complete to the best of my knowledge. Any misrepresentations or willful omissions of facts shall be sufficient cause for disqualification of this application or termination of employment. I acknowledge that the failure to provide requested employment or employer history which is material to the applicant's qualifications for employment or that the provision of statements which the applicant does not believe to be true in an application for a certified position may result in a Class A misdemeanor. I understand that any misrepresentations may lead to the withdrawal of any offer of employment or termination of employment if an employment relationship has begun.

I understand that an offer of employment (or the opportunity to continue my employment if I am hired before these requirements are fully satisfied) is contingent upon my passing the Illinois Department of State Police and Child Abuse Registry background investigations and submitting the required Form I-9, including evidence of identity and work authorization, the health and medical examination forms, including TB test results and drug/alcohol tests for safety sensitive positions, and any other forms required by Peoria Public Schools District 150 or by Illinois or federal law. I further understand that if I am offered a position of employment, I will be required to abide by the policies and regulations of Peoria Public Schools District 150, as those policies and regulations now exist or as they may be subsequently amended or altered.

General Questions

Please explain how your past personal and professional experience make you a quality candidate for the position.

Do you hold or anticipate an Illinois teaching certificate? If so, what is your Illinois Educator Identification Number (IEIN)?

Describe the skills or attributes you believe are necessary to be an outstanding teacher.

Can you speak, read, or write any language other than English? If so, please indicate below.

List any additional experiences, skills, or qualifications which will help in determining your professional qualifications for a position with Peoria Public School District 150.

Are you currently under contract with another school district? If yes, what district and when does it expire?

Have you ever worked for Peoria Public School District 150? If yes, please identify the dates of your employment, position(s) held, and reason(s) for leaving.

Have you ever failed to be re-hired by an employer, been asked to resign a position, resigned to avoid termination, or been terminated from any job? If yes, please explain the specifics and provide dates and the name, address, and telephone number of the employer(s).

Are you a relative of any board member, administrator, or supervisor who is currently serving the school district? If yes, please list their name, title, and relationship.

Can you perform all the essential job function(s) of the position(s) for which you are applying, with or without reasonable accommodation(s)?

Have you ever been convicted of a criminal offense other than a minor traffic violation? If yes, please explain the specifics including a statement of the accusation against you, dates of the incident and the proceeding, name of the court where the proceeding occurred, and the final disposition of the case(s). Pursuant to the Illinois Criminal Identification Act, Illinois Human Rights Act, and Illinois Juvenile Court Act, you are NOT obligated to disclose an arrest or a conviction ordered impounded, sealed, or expunged. You are NOT obligated to disclose an expunged juvenile record of conviction or arrest.

12. Have you ever been indicated or found guilty of child abuse with the Department of Child and Family Services or are you currently under investigation by any child protection or law enforcement agency for child abuse or neglect? If yes, please explain and provide any relevant dates.

Does your name appear on any sex offender database in any state or country or on the Illinois Murderer and Violent Offender Against Youth database?

Have you obtained tenure status in any other school district? If yes, where and when?

Have you ever been denied tenure? If yes, please explain the specifics including the name of the school district(s) and the date(s) of denial.

Have you ever had a teaching certificate or teaching license revoked or suspended or have you in any way been sanctioned by or is any charge or complaint now pending against you before a licensing, certification, or other regulatory agency or body, public, or private? If yes, please explain the specifics including the date of the proceeding, name of the agency or body where the proceeding took place, a statement of the accusation made against you, and the final disposition.

Are you now being investigated for any alleged misconduct or other alleged grounds of discipline by your current or previous employer? If yes, please provide the name of the employer and a statement of the accusations against you.

Is there any additional information with regard to serious misconduct or lack of moral qualification on your part that is not otherwise disclosed by your answers to questions in this application?

REFERENCE #1: Please provide the Full Name, Phone Number, Email, and Relationship Information for your Professional Reference

REFERENCE #2: Please provide the Full Name, Phone Number, Email, and Relationship Information for your Professional Reference

REFERENCE #3: Please provide the Full Name, Phone Number, Email, and Relationship Information for your Professional Reference

How did you hear about the open position?

Additional Information Works with students on Reading and Math in small groups Provides the academic materials needed for the program Communicates student progress to the Site Coordinator Maintains Communication about program and participants to the Site Coordinator Provide student instruction in Reading and Math Maintains student academic weekly progress through written reports Helps place students into appropriate small learning groups using current student data Provides academic materials for student participants in the program Provides student assessment data in written report format throughout the program