Substitute Application

Linn J4 School District
Substitute Teacher Application Form

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The Linn J4 School District is an equal opportunity employer. Qualified applicants will receive equal consideration. No question is asked for the purpose of unlawfully excluding any qualified applicant by reason of age, race, creed, color, handicap, sex, national origin, ancestry, arrest record, conviction record, or political affiliation.

An application shall be considered complete when the following have been received:
1. This completed form and
2. A copy of your Wisconsin Teaching license (to be uploaded as a .pdf file)

Full Name: *

Email: *

Address: *

Line 1

Line 2

City

State

Zip Code

Country

Mailing Address (if different): *

Line 1

Line 2

City

State

Zip Code

Country

Home Telephone: *

Cell Phone: *

Social Security Number: *

Education: Colleges attended

School 1:

Name/Location: *

Dates Attended:

From: *

To: *

Degree: *

Major/Minor: *

School 2:

Name/Location: *

Dates Attended:

From: *

To: *

Degree: *

Major/Minor: *

School 3:

Name/Location *

Dates Attended:

From: *

Degree: *

To: *

Major/Minor *

Certification

Please upload a .pdf file of your certification/license: *

Max file size: 20MB

Area of Certification 1:

Grade/Subjects(s): *

State Issuing License: *

Expiration Date: *

WI DPI Code Number: *

Area of Certification 2:

Grade/Subject(s): *

State Issuing License: *

Expiration Date: *

WI DPI Code Number: *

Area of Certification 3:

Grade/Subject(s): *

State Issuing License: *

Expiration Date: *

WI DPI Code Number: *

Do you hold a current Wisconsin teaching license?

Choose One *

Yes No

If yes, expiration date: *

Have you ever had a professional certificate or license revoked?

Choose One *

Yes No

If YES, please explain: *

Professional Educational Work Experience

District/School 1: *

Principal/Supervisor: *

Position: *

From/To: *

District/School 2: *

Principal/Supervisor: *

Position: *

From/To: *

District/School 3: *

Principal/Supervisor: *

Position: *

From/To: *

Requested Areas for Substituting

Please check the subject areas and grade levels in which you prefer to substitute. Check all that apply.

Certification Statement:
Please read the following statement and accept the terms.

I certify that I have fully read this application form, that all answers to questions in this application are true and complete to the best of my knowledge, and I agree that my misstatements or omissions of material fact may disqualify me for this position. A criminal background check will be performed before an applicant is offered a position.

I accept these terms: *

Yes No

Submit

Welcome to Traver School

Linn J4 School DistrictSubstitute Teacher Application Form

Education: Colleges attended

Certification

Professional Educational Work Experience

Requested Areas for Substituting

Certification Statement:Please read the following statement and accept the terms.

Linn J4 School District
Substitute Teacher Application Form

Certification Statement:
Please read the following statement and accept the terms.