929 Maple Avenue • Downers Grove, IL 60515 • Phone: (630) 852-0832
Fax: (630) 852-0880 • Website: www.dgchristian.org • Email: [email protected]
STAFF APPLICATION FORM
Applicant’s Name: _____________________________________________________________________
Last
First
Middle
Permanent Address: ____________________________________________________________________
Street
City
State/Zip
Permanent Phone: (_____)__________________________
Present Address: ______________________________________________________________________
Street
City
State/Zip
Present Phone: (_____) ____________________________
POSITION OF INTEREST:
_____ Principal
_____ Lead Classroom Teacher
_____ Teacher Assistant
_____ Substitute Teacher
_____ Secretary
_____ Other _____________________
(Art, Music, P.E., etc)
PREFERENCE OF AGE LEVEL:
_____ Preschool age 3
_____ Preschool age 4
_____ Kindergarten
_____ Grade 1
_____ Grade 2
_____ Grade 3
_____ Grade 4
_____ Grade 5
_____ Grade 6
_____ Grade 7
_____ Grade 8
Present Occupation: ___________________________________________________________________
____________________________________________________________________________________
REFERENCES:
Include a reference from someone who can comment on your teaching ability/secretarial skills and a
pastoral reference.
NAME/POSITION
COMPLETE ADDRESS
PHONE
RELATIONSHIP
____________________________________________________________________________________
____________________________________________________________________________________
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Downers Grove Christian School Staff Application
Page 2
PERSONAL
Place of Birth _________________________________________________________________________
City
State
Marital Status:
_____
_____
_____
_____
_____
If Married:
Single
Married
Separated
Divorced
Widowed
Number of Children __________
Maiden Name _________________________________
Spouse’s Name ________________________________
Ages of Children _____________________________________
Are you a U.S. Citizen? _____ Yes _____ No
Do you have any physical limitations that would prevent you from performing in this job?
____________________________________________________________________________________
____________________________________________________________________________________
Describe your present health condition:
____________________________________________________________________________________
____________________________________________________________________________________
What is your basic reason for seeking employment with our school?
____________________________________________________________________________________
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Downers Grove Christian School Staff Application
Page 3
Are you a Christian? _____ yes _____ no _____ uncertain
When were you saved: __________________________________________________________________
(Date or time in life)
What were the significant circumstances, Scripture and/or people involved in your coming to Christ?
____________________________________________________________________________________
____________________________________________________________________________________
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On what do you base your confidence that you are a Christian?
____________________________________________________________________________________
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What is your own evaluation of your current personal relationship with Jesus Christ?
____________________________________________________________________________________
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Church affiliation:
_____ Member _____ Regular Attender
Church Name: ________________________________________________________________________
Address: _____________________________________________________________________________
_____________________________________________________________________________
Are you in agreement with our Statement of Faith? _____ yes _____ no
Please explain briefly if you answered “no” to the above question:
____________________________________________________________________________________
____________________________________________________________________________________
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Downers Grove Christian School Staff Application
Page 4
PROFESSIONAL PREPARATION
Schools attended: List all High School, College, Graduate, and Summer Sessions
School Name/
City & State
Dates
Attended
Degrees
Conferred
Total
Semester Hours
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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Major area of study
__________________________________________________ Credits ________
__________________________________________________ Credits ________
__________________________________________________ Credits ________
Minor area of study
__________________________________________________ Credits ________
Number of education courses __________________________
Number of Christian Education courses ________________________
Immediate goals for further study _________________________________________________________
____________________________________________________________________________________
List those organizations in which you hold professional memberships: ___________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Special abilities: ______________________________________________________________________
____________________________________________________________________________________
Special interests or hobbies: _____________________________________________________________
____________________________________________________________________________________
Downers Grove Christian School Staff Application
Page 5
PRACTICE TEACHING EXPERIENCE:
School ________________________________________________________ Dates _________________
Subject _________________________________________________ Grade Level __________________
Are you certified? _____ yes _____ no
Type of certificate _____________________________________________________________________
State issued _______________________ Level and/or subject of certification ____________________
TEACHING EXPERIENCE
School Name/
City & State
Grade
Level
Description of
Position/Duties
Dates
Salary
(optional)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
WORK EXPERIENCE
Employer
Job Description
Dates
____________________________________________________________________________________
____________________________________________________________________________________
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Downers Grove Christian School Staff Application
Page 6
Describe what you envision to be the philosophy of a Christian school:
____________________________________________________________________________________
____________________________________________________________________________________
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What is your perspective on the nature and value of a child?
____________________________________________________________________________________
____________________________________________________________________________________
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How do you communicate worth to a child?
____________________________________________________________________________________
____________________________________________________________________________________
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Briefly describe your personal philosophy of classroom discipline:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
What are your beliefs on the origin of life?
____________________________________________________________________________________
____________________________________________________________________________________
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Downers Grove Christian School Staff Application
Page 7
In 250 words or less relate the experiences or influences in your life which have molded your thinking
and character.
____________________________________________________________________________________
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Signature of Applicant
_____/_____/_____
Date