Faculty Application Form (Page 4 of 4) in pdf

REFERENCES

Please provide three (3) professional references who can attest to your professional work and who have

knowledge of your work ability.

Name

Address

Telephone Number

________________________________________________________________________________________________

PROFESSIONAL STATEMENT

Write a brief statement stating your strengths and weaknesses as you see them for this position.

EMPLOYMENT APPLICATION CERTIFICATION

I hereby certify that all facts and information listed on this employment application are true and

complete. I understand that any false, incomplete or misleading information given by me on this application is

sufficient cause for rejection of this application. I also understand and agree that any such false, incomplete, or

misleading information on this application or provided in the hiring process which is discovered at any time after

I am employed may result in my dismissal.

I hereby authorize Bishop Kenny High School and the Diocese of Saint Augustine to investigate all

statements contained in this application, to interview the references and previous employers listed in this

application, and to obtain a report from a consumer reporting agency to be used for employment purposes in

accordance with the Fair Credit Reporting Act. I authorize the references and previous employers listed to give

Bishop Kenny High School and the Diocese of Saint Augustine all facts, opinions, and evaluations concerning

my previous employment and any other information they may have, personal or otherwise, and release all such

parties from any liability which may allegedly arise from furnishing such information to Bishop Kenny High

School and the Diocese of Saint Augustine, including, but not limited to, any liability for defamation or invasion

of privacy.

If I am offered employment, I understand that such an offer will be conditioned upon satisfactory results

of a background investigation and/or the Diocesan medical examination or inquiry, including fingerprinting

and/or drug screen. If then employed, I understand that I will be required to serve a (90) day probationary period.

I further understand that my employment and compensation can be terminated, with or without cause or notice,

at any time, regardless of the successful completion of my probationary period, at the option of either Bishop

Kenny High School or myself. I understand that no supervisor or other representative of Bishop Kenny High

School has any authority to enter into any agreement for employment for any specified period of time, or to make

any agreement contrary to the foregoing.

I further understand and voluntarily agree as a condition of employment or my continued employment,

that I may be requested by Bishop Kenny High School to submit urinalysis or other drug screen tests and that my

failure to take such test(s) when requested to do so, or unsatisfactory test results, will disqualify me from

consideration for employment, or if I am then employed, may result in my immediate dismissal.

I certify that I have read, understand, and agree with all the above.

_____________________________________________________________

________________________________

Signature of applicant

Date

Faculty Application Form Page 4