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North Harrison R-III School District

Employment Application
Applicant Information
It is the policy of the North Harrison R-III School District to provide equal employment opportunity regardless of race, religious creed, national origin, disability, sex, or age.

Administrative Office 12023 Fir Street Eagleville, Missouri 64442 Phone: 660-867-5222 Fax: 660-867-5263

Full Name: Address:






Street Address

Apartment/Unit #



ZIP Code

Phone: Date Available:

(     )             Social Security No.:

E-mail Address:      


Position Desired

List grades and/or subjects in order of preference. Elementary Middle School High School Other                              

Present position, occupation, or status: Expiration date of present contract:      

Name and address of placement bureau where credentials are on file: Are you available for a personal interview? YES Supervising Teacher:       Level/Subject Area:       NO


Preferred day and time:      

Student Teaching Experience
Date:       Place:      

Complete the items in this section only if the information does not appear on your resume. Do you hold a valid Missouri Certificate? YES NO Levels and areas of certification:       List any out of state certificates:      

High School, college, or professional honors or recognition:      

Experience with youth organizations or working with children:      

Total years teaching experience in elementary:       If currently employed, state reason for leaving present position: Present annual salary:      


High School:      

      Expected salary:       YES NO

Are you willing to complete your share of extra-classroom duties?

List duties or obligations that would interfere with your accepting any assignment, attending meetings, or participating in activities outside regular school hours:       Elementary candidates – List school clubs or after school activities you could supervise:       Secondary candidates – Check the activities you can direct, coach, or supervise: Debate Public Speaking Cheerleaders Golf Student Council Pep Club Softball Yearbook Track Wrestling School Newspaper Basketball Volleyball School Plays Football Other

List experience or training with the following: Cooperative Learning:       Inquiry-Based Instruction:       GLE Based Curriculum Development:       eMINTS Professional Development:       Technology Based Instruction:       Reading Correction:       SmartBoards:       Classroom Management Strategies:      

Why did you choose education as your profession? (Please limit to 250 words or less.)      

Applicant’s Statement
Applicant Statement portion of the district application must contain an original signature and should be mailed or faxed to the district office. Please read this statement carefully before signing. It is the policy of the North Harrison R-III School District to provide equal employment opportunity regardless of race, religious creed, national origin, disability, sex, or age.

1. I hereby authorize my current and former employers to furnish any information about me and my work experience. 2. I understand and consent to having a criminal and arrest records checks as well as background checks as a condition and consideration of my application for employment. In accordance with Missouri law, this background check will include a complete fingerprint criminal records check. 3. I certify that the answers given in my application packet are true and complete to the best of my knowledge. I also understand that, even if employed, falsified statements on my application or during interviews shall be grounds for termination of employment. 4. I acknowledge that my employment is contingent upon the District’s receipt of a clean criminal background check and child abuse/neglect report, each of which must be satisfactory to the District. _____________________________ Applicant’s signature _________________ Date