Application for Instructional Position in the Fayetteville-Manlius Central School District
First Name *
Last Name *
Middle Initial
Home Address *
City *
State *
Zip *
Home Phone *
Cell Phone:
Work Phone
Work Address
Retirement Number
Present Position
Salary
$
NYS Certification Test Dates (M/D/YYYY)
LAST
ATS-W
CST
Training
School Violence
Prevention & Intervention (M/D/YYYY)
Child Abuse Identification (M/D/YYYY)
NYS Certification (Please enter dates in M/D/YYYY format)
Area or Field of Certificate
for grades
Date Issued
Certification Code
Area or Field of Certificate
for grades
Date Issued
Certification Code
Area or Field of Certificate
for grades
Date Issued
Certification Code
Area or Field of Certificate
Out of State Certification
Area or Field of Certificate
for grades
Date Issued
State
Area or Field of Certificate
for grades
Date Issued
State
Educational Background
High
School *
Location *
Dates Attended
Type of Diploma
Date Granted
Distinctions and Honors
College/University *
Location *
Dates Attended
Type of Degree
Date Granted
Major *
Distinctions and Honors
Second College/University
Location
Dates Attended
Type of Degree
Date Granted
Major
Distinctions and Honors
Graduate Studies
Location
Dates Attended
Type of Degree
Date Granted
Major
Distinctions and Honors
Other Graduate Studies
Location
Dates Attended
Type of Degree
Date Granted
Major
Distinctions and Honors
Master's Degree
Yes
No
CAS
Yes
No
National Board Certification
Yes
No
ASHA Certification
Yes
No
PhD
Yes
No
Number of Graduate Semester Credit Hours
Employment History
Public School Teaching (List most recent experience first)
School
Location and Ph. Number
Grade or Subject
Total Years
Dates
School
Location and Ph. Number
Grade or Subject
Total Years
Dates
School
Location and Ph. Number
Grade or Subject
Total Years
Dates
College or University Teaching
School
Location and Ph. Number
Subject Area
Total Years
Dates
School
Location and Ph. Number
Subject Area
Total Years
Dates
Other Teaching (including substituting)
School
Location and Ph. Number
Grade or Subject
Total Years
Dates
School
Location and Ph. Number
Grade or Subject
Total Years
Dates
Student Teaching
School
Location and Ph. Number
Grade or Subject
Dates
School
Location and Ph. Number
Grade or Subject
Dates
Activities
Positions of leadership held or honors received in college, teaching, or in the community:
Experience in organizations you feel help qualify you for the position:
Recent participation in professional events:
Other Experiences with Children
Type of Experience
City and State
Kind of Work
Dates
Length of Service
Non - Teaching Work Experience
Name of Firm or Employer
City and State
Kind of Work
Dates
Length of Service
Military Service
In United States Armed Forces
Yes
No If yes, complete below
Length of Service
Branch
Date of Discharge
Professional References (* two required)
Name
Official Position
Institution
Present Address
Telephone
Please explain how you perceive your long-term purposes and contributions to the education of children.
Attach your resume:
Attach your cover letter:
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Have you been fingerprinted?
Yes
No
Have you submitted your fingerprints to New York State Ed. Dept.?
Yes
No
Have you ever been convicted of a felony?
Yes
No
Have you ever submitted an application to the Fayetteville-Manlius School District?
Yes
No
If so, for what position?
Position:
Date:
Have you ever been employed by the Fayetteville-Manlius School District?
Yes
No
If yes, date and position.
How did you learn about this opening?
Once submitted, you will not be able to view or edit your application. Please review carefully before submitting.
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The Fayetteville-Manlius School District does not discriminate on the basis of age, ethnic background, religion, creed, disability, marital status, gender, sexual orientation, veteran status, country of origin, or race in the educational programs and activities which it operates.
Fayetteville-Manlius District Office
8199 East Seneca Turnpike
Manlius, NY 13104
(315) 692-1234
