Teacher Application
Thank you for applying for a position at Calvary Day School. Please follow the directions
below carefully. Your application is complete when all forms are returned to the Head of
School’s Office, located in room E-1120. Only complete applications will be pursued.
Download and complete the Teacher Application. Be sure to use separate pages where
indicated with an asterisk (*) and provide copies of your transcript(s) and credentials.
Personal Reference Forms: Give one copy to your pastor and the other two forms to people
who are qualified to speak to your spiritual experience and Christian service. These forms may
be mailed, faxed, or sent by email to the Head of School’s Office.
Professional Reference Forms: Give these forms to people who are qualified to speak to your
professional training and experience. These forms may be mailed, faxed, or sent by email to the
Head of School’s Office.
Authorization for Release of Information & Records: include your first, middle, last name
and maiden name if applicable.
Email, fax, mail or bring the entire application to:
Calvary Day School
Attn: Brenda Lidbom
5000 Country Club Road
Winston-Salem, NC 27104
Phone: 336-765-5546 ● Fax: 336-714-5577
Email: [email protected]
Website www.calvaryday.school
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Teacher Application for Calvary Day School
Position desired: ___________________________ Full time: ________ Part time: ________
Application date: ______________
Date available: ______________________
Applicant’s Name and Address
Full name: Miss Mrs. Ms. Mr.____________________________________________________
Present Address: _______________________________________________________________
Street address / PO Box / Apt.
City
State
Zip code
Phone: Day _____________ Evening: ___________________ Cell: ___________________
Email _______________________________________________________________________
Marital Status
Personal Information
□ Single □ Engaged □ Married □ Separated □ Divorced
□ Remarried □ Widow(er)
* Please attach explanation if divorced or remarried.
Spouse’s name: ______________ Occupation: _______________
Years married: _______ Number of children/ages: __________
Finances
What was your most recent annual salary? __________________
Position Desired
(please check)
□ Early Education □ Kindergarten □ 1st Grade □ 2nd Grade
□ 3rd Grade □ 4th Grade □ 5th Grade □ 6th -8th Grades
□ High School Subject: __________________
Special Abilities
Other: __________________
Please list activities or sports you would be capable of and willing to direct,
sponsor, advise, or coach. (Indicate grade or ability levels.)
Christian Background:
Bible: Do you believe the Bible to be the ONLY inspired and infallible Word of God, our final authority
in all matters of faith, conduct, and truth? □ Yes □ No
Signature: _______________________________________________
Statement of Faith Please carefully read our Statement of Faith (located on page 6) and indicate below
your degree of support.
_____ I fully support the Statement as written without mental reservations.
Signature _______________________________________________
_____ I support the Statement except for the area(s) listed and explained on a separate paper. The
exceptions represent either disagreements for which I have not yet formed an opinion or conviction.
Signature________________________________________________
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Christian Background (continued)
In what church do you hold membership? ____________________________________________
Are you presently a member in good standing? _______________
Years __________
List name and address of other churches you have attended regularly during the past five years.
_____________________________________________________________________________________
_____________________________________________________________________________________
When did you make your profession of faith in Christ? ____________
When were you baptized? ________________________
In what church activities are you involved and with what degree of regularity?
_____________________________________________________________________________________
_____________________________________________________________________________________
Describe your routine of personal Bible study and prayer.
_____________________________________________________________________________________
_____________________________________________________________________________________
* On separate paper, briefly give your Christian testimony.
Professional Qualifications:
Please attach photocopies of all your college transcripts. Should you be offered a position, official copies
of your college transcripts will be required to be submitted for inclusion in your personnel files.
Educational Background
Degree
Your major:
Date Received
Issuing Institution
Cumulative GPA: BA ______
Graduate Work ______
Your minor:
Work Experience (Sequentially list your teaching experience with most recent first)
Place
Grades or Subjects
Dates
Phone Number
Years of experience teaching in: Public School _____ Christian School _____ Private School _____
Special Qualifications or Experience including instructional technology skills:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
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Teaching Credentials:
Do you have an ACSI Teaching Certificate? ______
Expiration date _______________
Attach a copy of your certificate to this application.
If yes, what level? _________________________
Do you have a state teaching license? ____________ If yes, what state ___________
What kind? _________________________________ Expiration date ____________________________
Endorsement(s) : List Semester hours in endorsement area(s).
Attach a copy of your license to this application.
If you do not hold a certificate, what requirements do you lack?
_____________________________________________________________________________________
.
Personal References:
Give three references that are qualified to speak of your spiritual experience and Christian service. List
your current pastor first. Provide these references with the Personal Reference Form and ask them to
return it to CBDS.
Name
Complete Address
Phone
Position
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
Professional References:
Give three references that are qualified to speak of your professional training and experience. List your
current or most recent principal or supervisor first. Provide these references with the Professional
Reference Form and ask them to return it to CBDS.
Name
Complete Address
Phone
Position
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Additional Information:
List memberships, offices, and honors obtained in:
High School_____________________________________________________________
College _________________________________________________________________
Currently _______________________________________________________________
List your hobbies and personal interests:
__________________________________________________________________________________
__________________________________________________________________________________
Are you presently being investigated or under a procedure to consider your discharge for misconduct by
your present employer? If yes, explain.
 Yes  No
____________________________________________________________________________________
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Have you ever been convicted of any offense involving dishonesty, breach of trust, child abuse, moral
turpitude, or any other type of crime? If yes, indicate the nature of offense, date, court, and disposition.
 Yes  No
____________________________________________________________________________________
Personal Philosophy:
* On a separate paper, label and succinctly answer in one or two paragraphs each of the questions
below.
A. Why do you wish to teach in a Christian school?
B. What are the main characteristics that distinguish a Christian school from a public school?
C. What do you consider to be the proper classroom atmosphere for learning?
D. What is your philosophy of discipline?
E. What areas do you feel are your strengths? Weaknesses?
F. What do you believe about the origin of the earth and humankind?
G. Please summarize any additional information you would like to present regarding your
candidacy for this position.
Current Issues:
We live in a pluralistic society with many conflicting beliefs and values. As a teacher, you may be
asked specific questions about controversial issues by your students. Your answer will come from your
personal convictions. We need to know the views of those that would be Christian role models for our
children. Please share your personal convictions as a Christian toward:
WINE, BEER, AND OTHER ALCOHOLIC BEVERAGES ___________________________________________
__________________________________________________________________________________
SMOKING AND CHEWING ______________________________________________________________
__________________________________________________________________________________
MARIJUANA AND OTHER DRUGS__________________________________________________________
___________________________________________________________________________________
ENTERTAINMENT (MUSIC/DANCING) ______________________________________________________
___________________________________________________________________________________
PRE-MARITAL SEX_____________________________________________________________________
___________________________________________________________________________________
DIVORCE AND REMARRIAGE_____________________________________________________________
___________________________________________________________________________________
SEXUAL ACTIVITY OUTSIDE CHRISTIAN MARRIAGE __________________________________________
__________________________________________________________________________________
ABORTION__________________________________________________________________________
__________________________________________________________________________________
HOMOSEXUALITY_____________________________________________________________________
__________________________________________________________________________________
LYING / CHEATING ___________________________________________________________________
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_________________________________________________________________________________
PERSONAL DEBT____________________________________________________________________
_________________________________________________________________________________
GOSSIP ___________________________________________________________________________
_________________________________________________________________________________
APPLICANT’S CERTIFICATION AND AGREEMENT
The information contained in this application is correct to the best of my knowledge. I authorize any
references or churches listed in this application to give you any information (including opinions) that they
may have regarding my character and fitness for work in this ministry area. In consideration of the
receipt and evaluation of this application by Calvary Day School, I hereby release any individual, church,
youth organization, charity, employer, reference, or any other person or organization, including record
custodians, both collectively and individually, from any and all liability for damages of whatever kind or
nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts
to comply, with this authorization. I waive any right that I may have to inspect any information provided
about me by any person or organization identified by me in this application.
I further state that I have carefully read the foregoing release and know the contents thereof and I sign this
release as my own free act. This is a legally binding agreement which I have read and understand. I
understand that this is only an application for employment and that no employment contract is being
offered at this time. I certify that I have carefully read and do understand the above statements.
_______________________________________________
Applicant’s Signature
________________
Date
DECLARATION OF ETHICAL AND MORAL INTEGRITY
As an applicant for employment at Calvary Day School I, _____________________________ recognize,
understand, and agree to live by the moral and ethical standards of the church and school. I further
declare that with regard to my personal moral and ethical character and conduct as of this date, I am not,
nor have I been in the past engaged in inappropriate conduct toward minors, nor do I have inclinations
toward such conduct. (Inappropriate conduct includes the following: homosexuality, verbal, physical or
sexual abuse as defined by Scripture and state law.) I do declare that the above statement is factual and
true.
By affixing my signature, I declare that I meet the moral and ethical standards of Calvary Baptist Church
and Calvary Day School.
If you are uncomfortable with answering any of the following four questions, you may request a private
conference with the interviewer, or the Human Resources Coordinator to discuss these questions.
1. Have you ever been accused of child abuse? Yes_____ No_____
2. Were you ever subjected to abuse as a child? Yes_____ No_____
3. Is there anything in your past that could adversely affect your ability to work with children or
youth? Yes_____ No_____
4. Is there anything in your past that could bring reproach upon the church and school if it
became public knowledge? Yes_____ No_____
______________________________________________
Applicant's Signature
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_______________________
Date
CALVARY DAY SCHOOL STATEMENT OF FAITH
Calvary Day School affirms the Association of Christian Schools International (ACSI) Statement of Faith as a
member school of ACSI.
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We believe the Bible to be the inspired, the only infallible, authoritative, inerrant Word of God (2 Timothy
3:16, 2 Peter 1:21).
We believe there is one God, eternally existent in three persons—Father, Son, and Holy Spirit (Genesis 1:1,
Matthew 28:19, John 10:30).
We believe in the deity of Christ (John 10:33), His virgin birth (Isaiah 7:14, Matthew 1:23, Luke 1:35), His
sinless life (Hebrews 4:15, 7:26), His miracles (John 2:11), His vicarious and atoning death (1 Corinthians
15:3, Ephesians 1:7, Hebrews 2:9), His Resurrection (John 11:25, 1 Corinthians 15:4), His Ascension to the
right hand of God (Mark 16:19), His personal return in power and glory (Acts 1:11, Revelation 19:11).
We believe in the absolute necessity of regeneration by the Holy Spirit for salvation because of the
exceeding sinfulness of human nature, and that men are justified on the single ground of faith in the shed
blood of Christ, and that only by God’s grace and through faith alone are we saved (John 3:16–19, 5:24;
Romans 3:23, 5:8–9; Ephesians 2:8–10; Titus 3:5).
We believe in the resurrection of both the saved and the lost; that they are saved unto the resurrection of
life, and that they are lost unto the resurrection of condemnation (John 5:28–29).
We believe in the spiritual unity of believers in our Lord Jesus Christ (Romans 8:9, 1 Corinthians 2:12–13,
Galatians 3:26–28).
We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a
godly life (Romans 8:13–14; 1 Corinthians 3:16, 6:19–20; Ephesians 4:30, 5:18).
Calvary Day School states as its Statement of Faith that it adheres to the doctrinal position of Calvary Baptist
Church of Winston-Salem, Inc., as outlined in the Baptist Faith and Message (2000). This document may be viewed
at http://www.sbc.net/bfm2000/bfm2000.asp.
CALVARY DAY SCHOOL LIFESTYLE STATEMENT
Calvary Day School is a religious, nonprofit organization representing Jesus Christ throughout the evangelical
community worldwide. Calvary Day School requires its employees to be evangelical Christians who know the Lord
Jesus Christ as personal Savior and live their lives as Christian role models both in and out of school (Romans 10:910; I Timothy 4:12; Luke 6:40). Employees will conduct themselves in a way that will not raise questions regarding
their Christian testimonies. A Christian lifestyle should reflect the biblical perspective of integrity and appropriate
personal and family relationships, business conduct, and moral behavior. An employee is expected to demonstrate a
teachable spirit, an ability to share love for others, a willingness to live contentedly under authority, and a
commitment to follow the Matthew 18 principle when an issue arises with fellow employees, constituents, or
administration.
CDS expects employees to maintain a lifestyle based on biblical standards of moral conduct. Moral misconduct,
which violates the bona fide occupational qualification for employees to be Christian role models, includes, but is
not limited to, promiscuity, homosexual behavior and/or sexual orientation, bisexuality, polygamy, transgender
identity, or any other violation of the unique roles of male and female, and such activities as the use of alcohol and
illicit drugs and vulgar or profane language (Exodus 20:14; Leviticus 18:7-23; 20:10-21; Deuteronomy 5:18;
Matthew 5:27-28; 15:19; Romans 1:21-27; I Corinthians 6:9-20; Titus 2:7-8; I Thessalonians 2:10; James 3: 17-18).
CDS believes that the term “marriage” has only one meaning: the uniting of one man and one woman in a single,
exclusive covenant union, as delineated in Scripture (Genesis 2:18-25), and that God has commanded that no
intimate sexual activity be engaged in outside of marriage between a man and a woman (Genesis 1:27-28; 2:21-24;
Matthew 19:4-9; Mark 10:5-9; Ephesians 5:22-33).
To preserve Calvary Day School’s function and integrity its employees must be born-again Christians, living their
lives as Christian role models (Romans 10:9-10; I Timothy 4:12), maintaining a lifestyle based on biblical standards
of conduct. Failure to do so may result in a reprimand or, in some cases, dismissal from employment. It is the goal
of Calvary Day School that each employee will have a lifestyle where “. . .He (Christ) might have the preeminence.”
(Colossians 1:18)
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Para informacion en espanol, visite www.ftc.gov/credit o escribe a la FTC Consumer Response Center,
Room 130-A 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.
A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of
information in the files of consumer reporting agencies. There are many types of consumer reporting
agencies, including credit bureaus and specialty agencies (such as agencies that sell information about
check writing histories, medical records, and rental history records). Here is a summary of your major
rights under the FCRA. For more information, including information about additional rights, go to
www.ftc.gov/credit or write to: Consumer Response Center, Room 130-A, Federal Trade
Commission, 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.
 You must be told if information in your file has been used against you. Anyone who uses a
credit report or another type of consumer report to deny your application for credit, insurance, or
employment – or to take another adverse action against you – must tell you, and must give you
the name, address, and phone number of the agency that provided the information.
 You have the right to know what is in your file. You may request and obtain all the
information about you in the files of a consumer reporting agency (your “file disclosure”). You
will be required to provide proper identification, which may include your Social Security number.
In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
 a person has taken adverse action against you because of information in your credit
report;
 you are the victim of identify theft and place a fraud alert in your file;
 your file contains inaccurate information as a result of fraud;
 you are on public assistance;
 you are unemployed but expect to apply for employment within 60 days.
In addition, by September 2005 all consumers will be entitled to one free disclosure every 12
months upon request from each nationwide credit bureau and from nationwide specialty
consumer reporting agencies. See www.ftc.gov/credit for additional information.
 You have the right to ask for a credit score. Credit scores are numerical summaries of your
credit-worthiness based on information from credit bureaus. You may request a credit score from
consumer reporting agencies that create scores or distribute scores used in residential real
property loans, but you will have to pay for it. In some mortgage transactions, you will receive
credit score information for free from the mortgage lender.
 You have the right to dispute incomplete or inaccurate information. If you identify
information in your file that is incomplete or inaccurate, and report it to the consumer reporting
agency, the agency must investigate unless your dispute is frivolous. See www.ftc.gov/credit for
an explanation of dispute procedures.
 Consumer reporting agencies must correct or delete inaccurate, incomplete, or
unverifiable information. Inaccurate, incomplete or unverifiable information must be
removed or corrected, usually within 30 days. However, a consumer reporting agency may
continue to report information it has verified as accurate.
 Consumer reporting agencies may not report outdated negative information. In most cases, a
consumer reporting agency may not report negative information that is more than seven years old,
or bankruptcies that are more than 10 years old.
 Access to your file is limited. A consumer reporting agency may provide information about you
only to people with a valid need -- usually to consider an application with a creditor, insurer,
employer, landlord, or other business. The FCRA specifies those with a valid need for access.
 You must give your consent for reports to be provided to employers. A consumer
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reporting agency may not give out information about you to your employer, or a potential
employer, without your written consent given to the employer. Written consent generally is not
required in the trucking industry. For more information, go to www.ftc.gov/credit.
 You may limit “prescreened” offers of credit and insurance you get based on information in
your credit report. Unsolicited “prescreened” offers for credit and insurance must include a tollfree phone number you can call if you choose to remove your name and address from the lists
these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567-8688.
 You may seek damages from violators. If a consumer reporting agency, or, in some cases, a
user of consumer reports or a furnisher of information to a consumer reporting agency violates
the FCRA, you may be able to sue in state or federal court.
 Identity theft victims and active duty military personnel have additional rights. For more
information, visit www.ftc.gov/credit.
States may enforce the FCRA, and many states have their own consumer reporting laws. In some
cases, you may have more rights under state law. For more information, contact your state or local
consumer protection agency or your state Attorney General. Federal enforcers are:
TYPE OF BUSINESS: CONTACT:
Consumer reporting agencies, creditors and others not listed below Federal Trade Commission: Consumer Response Center FCRA
Washington, DC 20580 1-877-382-4357
National banks, federal branches/agencies of foreign banks (word "National" or initials "N.A." appear in or after bank's name)
Office of the Comptroller of the Currency
Compliance Management, Mail Stop 6-6
Washington, DC 20219 800-613-6743
Federal Reserve System member banks (except national banks, and federal branches/agencies of foreign banks)
Federal Reserve Board
Division of Consumer & Community Affairs
Washington, DC 20551 202-452-3693
Savings associations and federally chartered savings banks (word "Federal" or initials "F.S.B." appear in federal institution's name)
Office of Thrift Supervision
Consumer Complaints
Washington, DC 20552 800-842-6929
Federal credit unions (words "Federal Credit Union" appear in institution's name)
National Credit Union Administration
1775 Duke Street
Alexandria, VA 22314 703-519-4600
State-chartered banks that are not members of the Federal Reserve System
Federal Deposit Insurance Corporation
Consumer Response Center, 2345 Grand Avenue, Suite 100
Kansas City, Missouri 64108-2638 1-877-275-3342
Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission
Department of Transportation , Office of Financial Management
Washington, DC 20590 202-366-1306
Activities subject to the Packers and Stockyards Act, 1921 Department of Agriculture
Office of Deputy Administrator - GIPSA
Washington, DC 20250 202-720-7051
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Personal Reference Form
______________________________ has applied for a position with Calvary Day School and we seek
your opinion on the applicant’s character, personality, and ability to fill this position. The applicant has
also agreed that we have the right to keep your reference confidential. Thank you for your help.
How long have you known the applicant?
What capacity? (e.g. Pastor, Teacher, Friend)
Has this applicant demonstrated a commitment to Christian living both on and off the job site?
Would this applicant be a good Christian role model for students? _______________________________
Have you noted depth of convictions as demonstrated by honesty, fairness, respect for authority,
diligence, compassion, tact, and other Christian virtues? _______________________________________
____________________________________________________________________________________
List principal character and personality strengths _____________________________________________
____________________________________________________________________________________
Are there character or personality weaknesses that diminish this applicant’s effectiveness as a role model?
______________________________________________________________________________
Do you consider this applicant a self-starter, willing to do extra tasks if needed?
________
COMMENTS? (Please list on a separate sheet)
References: Please provide the name and address of two other references who know this applicant.
1. ___________________________________________________________________________
2. ___________________________________________________________________________
Your Name:
______________
Your Address:
Phone:
Email: ________________________________________________________
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______
_______
Professional Reference Form
___________________________________ has applied for a teaching position at Calvary Day
School, and we seek your opinion regarding this applicant’s character, personality, and ability to
fill a teaching position. This applicant has agreed that we have the right to keep your reference
report confidential. Thank you for your help.
Position(s) held:
Dates of service:
Full time
Part time
Reason for leaving:
Would you re-employ?
How would you rank this person as compared to others that you have supervised?
 Top 5%
 Next 20%
 Middle 50%
 Low 25%
Has this applicant demonstrated a real commitment to Christian living both on and off campus?
Is he/she a good role model for students?
List the applicant’s principal character and personality strengths
Are there character or personality weaknesses that might diminish this applicant’s effectiveness
as a Christian role model?
Your Name:
Position:
Name of organization:
Phone:
Email: __________________________________________________________
Reference Form continues on reverse side.
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Professional Reference Form, Page 2
Please check the column that most closely applies:
1=Outstanding 2=Above average 3= Satisfactory 4=Needs to improve 5=No opportunity to observe
Teacher Performance
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4
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Provides for Biblical integration in subject areas
Is consistently thorough in lesson planning and in securing necessary materials
Uses a variety of teaching techniques and resources
Demonstrates a knowledge of subject matter
Understands and relates effectively to student needs/maturity
Exhibits ability to arouse interest and to stimulate intellectual growth
Is fair, firm, and consistent with students
Maintains effective classroom control
Develops appropriate relationships with students
Demonstrates assertive leadership as a teacher
Maintains voice control in the classroom
Provides a well organized, attractive classroom
Professionalism
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Follows ethical and professional practices
Develops appropriate relationships with administration and staff
Is assertive and authoritative as a staff member at appropriate times
Accepts and acts upon supervisory guidance
Follows through on assignments
Is accurate and prompt in record keeping and in responding to communications
Is punctual at post of duty
Makes good decisions after considering necessary information
Develops appropriate relationships with parents
Is a builder of loyalty and good will to the employer
Displays emotional stability
References: Please provide the name, address, and phone number of two other potential references.
1.________________________________________________________________________________________________
2.________________________________________________________________________________________________
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