WARSAW CHRISTIAN SCHOOL
TEACHER APPLICATION PACKET
909 South Buffalo Street, Warsaw, Indiana 46580
Ph. 574. 267.5788 574. 267.1486 Fax
TEACHER
APPLICATION FORM
www.warsawchristian.org
[email protected]
Application date: ______/______/_____
Date Available: ______/______/_______
Your interest in Warsaw Christian School is appreciated. We invite you to fill out this application and return it to our
school office. If an opening occurs for which it appears you may qualify, we will request that you have your placement
file forwarded to our office. We may also contact your references. If we have continued interest in your candidacy, we
will contact you for a personal interview.
We realize that the key to a successful Christian School is its staff. We are grateful for those who are professionally
qualified, who really love children, and who, by the pattern of their lives, are Christian role models (Luke 6:40).
We look forward to receiving your application. Thank you for your interest in the ministry of Warsaw Christian School.
It is our prayer that God will fulfill His perfect will in the lives of all applicants.
A. APPLICANT'S NAME AND ADDRESS
_________________________________________________________________________________________________
Last name
First name
Middle initial
______________________________________________________________________________________________________________________
Street Address
City, State
Zip
______________________________________________________________________________________________________________________
Home phone #
Cell Phone #
Best time to call
Last 4 digits of SS#
How long have you been at the above address?_____
B. POSITION DESIRED
Full time ____________
Part time _______________
Please indicate 1, 2, 3 choice in the parenthesis. Then to the right please indicate the age, grade or subject in order of
preference.
Preference
___ Preschool __________________________________________________________________________
___ Kindergarten _______________________________________________________________________
___ Elementary ________________________________________________________________________
Special Abilities
List any experience, skills, or qualifications you have that would especially equip you for employment
in our school. Please include activities, events or sports that you would be capable of and willing to
direct, sponsor, advise, or coach. Indicate grade or ability levels where appropriate.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Do you belong to any professional groups or organizations relevant to your ability to fulfill your
assignment at our school?
_____________________________________________________________________________________
_____________________________________________________________________________________
C. CHRISTIAN BACKGROUND
*Attach a typed copy of your personal Christian testimony. Sign and date at bottom of the page.
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 ___
Are you capable to teach a Bible class?
Yes ___ No ___
Statement of Faith
Please carefully read our Statement of Faith and indicate below your degree of support:
____ I fully support the Statement as written without mental reservations.
____ I support the Statement except for the area(s) listed and explained on a separate paper.
The exceptions represent either disagreements or items for which I have not yet formed an
opinion or conviction.
Do you strongly hold to any doctrines not listed on the document? If yes, list and describe.
_____________________________________________________________________________________
_____________________________________________________________________________________
Church
Denominational preference? _____________________________________________________________
What is your local church affiliation? ______________________________________________________
How long have you been attending? __________
Are you a member? ________________
Service
What church activities are you involved and with what degree of regularity?
_____________________________________________________________________________________
_____________________________________________________________________________________
What other Christian service have you done since becoming a Christian that has prepared you to teach in
a Christian School?
_____________________________________________________________________________________
_____________________________________________________________________________________
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Have you ever led a child or person to Christ? ___ Yes ___ No Please give a brief explanation.
____________________________________________________________________________________________
____________________________________________________________________________________________
Devotional Life
Describe your routine of personal Bible study and prayer. _____________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What books or periodicals have you read recently that have helped you spiritually? _________________________
____________________________________________________________________________________________
D. PERSONAL INFORMATION
Being a Christian role model in all aspects of life is a major requirement for this position. The Bible is our
standard for marriage and sexual conduct. It is a bona fide occupational requirement for staff to live by those
standards. Please indicate your current marital status.
Single ___ Engaged ___ Married ___ Separated ___ Divorced ___ Remarried ___ Widow(er) ___
Please attach explanation if divorced or remarried.
Spouse's name _______________________ Years married ______ Spouse’s occupation ___________________
What was your most recent annual salary? _______________________________________________________
Our school board has adopted the policy that all children of the faculty must attend this school if it has the
appropriate grades and programs. Please provide the following information:
Names of children ________________________________________
Grade level or ages ________________
If you answer, “Yes” to any of the following questions below (numbers 1-6), please attach a separate sheet
indicating the nature of the suit, offense, date, court, and disposition or other appropriate explanation.
1. Are you presently being investigated or under a procedure to consider your discharge for misconduct by your
present employer? ____ Yes ____ No
2. Has any employer ever subjected you to disciplinary action, suspended, terminated, or asked you to leave a job
or volunteer position on the grounds of any unlawful sexual behavior, or violation of an employer’s sexual
misconduct or harassment policy?
___ Yes
___ No
3. Have you ever been charged in civil or criminal proceedings with improprieties regarding children?
____ Yes
____ No
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4. Have you ever entered a plea of guilty, a plea of “no contest” (nolo contendere), or has any court ever deferred
further proceedings without entering a finding of guilty and placed you on probation or in a public service or
education program for any crime other than a minor traffic offense?
____ Yes
____ No
5. Have you ever been suspended, discharged, or resigned in lieu of being discharged from any position?
___ Yes
__ No
6. Have you ever been convicted of any offense involving dishonesty, breach of trust, stealing, any type of moral
impropriety, or any other type of felony?
___ Yes ___ No
7. Have you read the job description and essential functions for this position? ___ Yes
___ No
Is there any reason why you might be unable to perform the essential duties and responsibilities of the position for
which you are applying?
__ Yes __ No If yes, please explain____________________________________________________________
If you answered "yes" to above question, is there anything that the school can do to reasonably accommodate your
needs so that you would be qualified to perform the duties and responsibilities of this position?
___________________________________________________________________________________________
___________________________________________________________________________________________
Do you have any personal responsibilities or other commitments that may prevent you from meeting this
position’s requirements for on–time arrival, attendance, or work schedules?
_____________________________________________________________________________________________________________________________
E. 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 file.
Formal Training
What degree or degrees do you hold?
Degree
Date Received
Issuing Institution
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
Your Major(s) _____________________________________________________________________________________________________________
Your Minor (s) ____________________________________________________________________________________________________________
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To what degree are you familiar with various Christian or secular curriculums? ___________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Curriculum Preferences? _______________________________________________________________________
___________________________________________________________________________________________
List any other educational advantages that you have had including opportunities for travel or books or
periodicals you have read recently that have helped you grow professionally.______________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Teaching Credentials
Do you have an ACSI Teaching Certificate? ___ Yes ___ No If yes, provide the following:
Certification area _________________________
Type _________
Expiration date ____________
Do you have a state teaching certificate? ___ Yes ___ No If yes, provide the following: State? ________
Certification area _________________________
Type _________
Expiration date ____________
Endorsement(s). _____________________________________________________________________________
___________________________________________________________________________________________
If you do not hold a certificate, what requirements do you lack or how long would it take to get certified?
____________________________________________________________________________________________
* Please attach photocopies of any certificate held.
Christian School Preparation
Have you had any courses in the Christian Philosophy of Education? If so, where and when?
___________________________________________________________________________________________
If not, would you be willing to take an approved course offered by ACSI? ________________________________
Have you had other courses giving specific training for Christian elementary schools? ______________________
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Give details _________________________________________________________________________________
___________________________________________________________________________________________
List any conferences or seminars in which you have led or participated in the past.
___________________________________________________________________________________________
___________________________________________________________________________________________
Describe how teacher evaluations have been helpful to you or attach a copy of a recent teacher evaluation from
your supervisor or principal.
___________________________________________________________________________________________
___________________________________________________________________________________________
F. PERSONAL PHILOSOPHY
*Attach a typed copy of your personal Christian Philosophy of Education.
*On separate paper please label and succinctly answer in one or two paragraphs each of the questions
below.
Short Essays
1. Why do you wish to teach in a Christian school?
2. What are the main characteristics that distinguish a Christian school from a public school, charter school or
secular private school?
3. What do you consider to be a proper classroom atmosphere for learning?
4. What is your philosophy of discipline? Attitude toward physical punishment?
5. How will you handle a child’s question if you know that it is theologically controversial and the family’s
church holds to a different viewpoint than your own?
6. What areas do you feel are your strengths? Areas needed for improvement or professional growth?
7. What do you believe about the origin of the earth and mankind?
8. Please summarize any additional information that you would like to present regarding your
candidacy for this position.
G. 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 answers will come from your personal convictions.
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We need to know the views of those that would be Christian role models for our children. Below or on a
separate sheet of paper, please share your personal convictions as a Christian toward the following issues in one
or two brief paragraphs:
Use of: wine, beer, and other alcoholic beverages; use of tobacco; pre-marital sex; divorce and remarriage;
abortion, homosexuality; lodges and secret societies; sexual activity outside Christian marriage; personal debt.
H. EMPLOYMENT HISTORY
Please start with your current or most recent employer and work backwards for the past five- ten years. If necessary, you
may make copies of this page if space is needed.
Non-Teaching Experience
Employer _________________________________________________________________________________
Position______________________________ Dates of Employment _________________________________
Address __________________________________________________________________________________
_________________________________________________________________________________________
Supervisor's name and phone number___________________________________________________________
Reason for leaving__________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Employer_________________________________________________________________________________
Position______________________________ Dates of Employment__________________________________
Address __________________________________________________________________________________
_________________________________________________________________________________________
Supervisor's name and phone number___________________________________________________________
Reason for leaving__________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Employer_________________________________________________________________________________
Position______________________________ Dates of Employment__________________________________
Address __________________________________________________________________________________
_________________________________________________________________________________________
Supervisor's name and phone number___________________________________________________________
Reason for leaving__________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Professional/Teaching Experience
School/District_____________________________________________________________________________
Position______________________________ Dates of Employment _________________________________
Address __________________________________________________________________________________
_________________________________________________________________________________________
Supervisor's name and phone number___________________________________________________________
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Reason for leaving _________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
School/District ____________________________________________________________________________
Position______________________________ Dates of Employment _________________________________
Address __________________________________________________________________________________
_________________________________________________________________________________________
Supervisor's name and phone number___________________________________________________________
Reason for leaving _________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
School/District ____________________________________________________________________________
Position______________________________ Dates of Employment _________________________________
Address _________________________________________________________________________________
_________________________________________________________________________________________
Supervisor's name and phone number___________________________________________________________
Reason for leaving _________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Have you ever worked under a different name for any of the employers you have listed? If so, what was the name
or names?
Have you already signed a contract for next year with any other institution?
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Yes ____ No _____
I. REFERENCES
You will need to sign the Reference Release and include it with each reference form and send the appropriate form to the
names you list below. Do not list family members or relatives for references.
Non-Teaching Reference
Select two non-teaching employer references that are qualified to speak of your work experience from the list
of references you provided on the previous page.
Name
Complete Address
Phone
Position
1. ________________________________________________________________________________________
________________________________________________________________________________________
2. ________________________________________________________________________________________
________________________________________________________________________________________
Professional/Teaching Reference
Select two professional/teaching employer references that are qualified to speak of your teaching experience
from the list of references you provided on the previous page.
Name
Complete Address
Phone
Position
1. ________________________________________________________________________________________
________________________________________________________________________________________
2. ________________________________________________________________________________________
________________________________________________________________________________________
Personal Give two references that are qualified to speak of your spiritual experience and walk with the Lord.
Name
Complete Address
Phone
Position
1. ________________________________________________________________________________________
________________________________________________________________________________________
2. ________________________________________________________________________________________
________________________________________________________________________________________
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APPLICANT'S CERTIFICATION AND AGREEMENT
I understand that Community Grace Brethren Church d/b/a Warsaw Christian School does not discriminate in its
employment practices against any person because of race, color, national or ethnic origin, gender, age, or disability.
I hereby certify that the facts set forth in this application are true and complete to the best of my knowledge. I understand
that discovery of falsification of any statement or a significant omission of fact may prevent me from being hired, or if
hired, may subject me to immediate dismissal regardless of the time elapsed before discovery. If I am released under
these circumstances, I further understand that I will be paid and receive benefits only through the day of release.
I authorize Warsaw Christian School to thoroughly investigate references, work records, evaluations, education, and
other matters related to my suitability for employment.
I authorize references and my former employers to disclose to the school any and all employment records, performance
reviews, letters, reports, and other information related to my life and employment, without giving me prior notice of such
disclosure.
In addition, I hereby release Warsaw Christian School, my former employers, references, and all other parties from any
and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.
I waive the right to ever personally view any references given to Warsaw Christian School.
Since I will be working with children, I understand that I must submit to a fingerprint check by the FBI and possibly other
federal and state authorities. I agree to fully cooperate in providing and recording as many sets of my fingerprints as
necessary for such an investigation. I will voluntarily submit this report within 30 days of being issued a contract,
including a fingerprint check taken by an appropriate law enforcement agency. I understand that if the finger printing and
applications are not completed in 30 days, my contract can be revoked. I authorize Warsaw Christian School to conduct
a criminal records check.
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 name (print)
_________________________________________
Applicant's signature
_________________________________________
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Date
AUTHORIZATION TO RELEASE REFERENCE INFORMATION
I have made application for a position as a _____________________________________ with Warsaw
Christian School. I have authorized the school to thoroughly investigate references, work records, evaluations,
education, and other matters related to my suitability for employment.
I authorize references and my former employers to disclose to the school any and all employment records,
performance reviews, letters, reports, and other information related to my life and employment, without giving
me prior notice of such disclosure.
In addition, I hereby release Warsaw Christian School, my former employers, references, and all other parties
from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or
disclosure.
I waive the right to ever personally view any references given to Warsaw Christian School.
I certify that I have carefully read and do understand the above statements.
_________________________________________
Applicant's name (print)
_________________________________________
Applicant's signature
_________________________________________
Applicant's last 4 digits of social security number
_________________________________________
Date
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DECLARATION OF ETHICAL AND MORAL INTERGRITY
Our school expects all of its employees and its volunteers with unsupervised access to children to model the same
Christian values and lifestyle that it seeks to inculcate in its students. As an applicant for a ministry position as an
employee or as a volunteer position at Warsaw Christian School, and its ministries, I (print
name)_________________________________________________________ recognize, understand, and agree to live by
the Christian moral and ethical standards of the school.
I declare that during the past year I have not engaged in, at the current time I am not engaging in, and promise that I will
not during the term of my employment or volunteering, engage in inappropriate sexual conduct. Inappropriate conduct
includes, but is not limited to, such behaviors as the following: heterosexual activity outside of marriage (e.g., premarital
sex, cohabitation, and extramarital sex), homosexual or lesbian sexual activity, sexual harassment, use or viewing of
pornographic material or websites, or sexual abuse or improprieties toward minors as defined by Scripture and federal or
state law.
I do declare that the above statement is factual and true. By affixing my signature, I declare that I meet the moral
integrity standards and Christian role model lifestyle requirements of Warsaw Christian School.
_______________________________________________
Applicant’s signature
___________________________
Date
_______________________________________________
Administrator’s signature after discussion with applicant
___________________________
Date
“Honor marriage, and guard the sacredness of sexual intimacy between wife and husband. God draws a firm line against casual and
illicit sex.” Hebrews 13:4 The Message
“A pupil is not superior to his teacher, but everyone (when he is) completely trained-readjusted, restored, set to rights, and perfectedwill be like his teacher.” Luke 6:40 The Amplified Bible
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