Application for Substitute Teacher & Substitute … - substitute paraprofessional nominations

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For Internal Use:
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Application for Substitute Teacher & Substitute Paraprofessional
Your Information
Last Name: First Name: Middle Initial:
Street Name and Number:
Home Address City: State: Zip Code:
Contact Telephone Number:
Information Email Address:
Desired Position
Please check all options that you are willing to work.
Desired Position Preferred Grade Level
(Check all that apply) (Check all that apply)
Substitute Teacher (Proof of Bachelor's Degree Required) Elementary K-5
Substitute Paraprofessional (Bachelor's Degree Not Required) Middle School 6-8
High School 9-12
Preferred Schools Availability For Paraeducators only:
(Check all that apply) (Check all that apply) Please indicate time preference.
East Elementary Mondays AM PM Full Day
Foster Elementary Tuesdays AM PM Full Day
Plymouth River Elementary Wednesdays AM PM Full Day
South Elementary
Hingham Middle School Thursdays AM PM Full Day
Hingham High School Fridays AM PM Full Day
Preferred Subject (if any) Start Date Availability:
I am available to start work on:
Massachusetts Licensure
License Number: Original Certification Date:
Field/Level Type Issue Date Expiration Date
Educational Background
Degree Type School Name City/State Major Minor Degree Date
High School N/A N/A
Bachelors
1 ver 1 - 5/26/2021
Application for Substitute Teacher & Substitute Paraprofessional
Teaching Experience - Not Including Student Teaching
Date - From Date - To Yrs Taught Grade Subject School City/State
Have you ever been employed by the Hingham Public Schools? Yes No
If yes, in what role?
Teaching Experience -Student Teaching
Date - From Date - To Yrs Taught Grade Subject School City/State
Other Work Experience with Children
Date - From Date - To Role Employer
Other Work Experience
Date - From Date - To Role Employer
Military Experience
Date - From Date - To Branch of Service Rank
2
Application for Substitute Teacher & Substitute Paraprofessional
References
Indicate below three references capable of evaluating your work. These may or may not be duplicate
references in your personnel file. If you are an experienced teacher, include your most recent employer in
this listing. If you are an inexperienced teacher, include your cooperating teacher and/or principal with
whom you student taught.
Name Role Institution Email Phone
Massachusetts General Law c. 149, section 19B requires the following statement: It is unlawful in Massachusetts to
require or administer a lie detector test as a condition of employment or continued employment. An employer who
violated this law shall be subject to criminal penalties and civil liability.
Applications for employment are accepted without regard to race, color, religion, sex, sexual orientation, age,
national origin, veteran status, qualified disability, or marital status.
Your Acknowledgement and Signature
? The information provided in this document is accurate, truthful, and complete to the best of my
knowledge.
? In the event of employment, I understand that false or misleading information given in my application
or interview may result in discharge. I also understand that I will abide by all rules, regulations, policies,
and procedures of the Hingham Public Schools.
? I understand that any employment offer by the Hingham Public Schools is conditional upon my ability
to establish employment eligibility under the Immigration Reform and Control Act of 1986.
? I understand that any employment offer by the Hingham Public Schools is conditional upon acceptable
pre-employment screening, including, but not limited to, receipt of references that the employer
considers satisfactory, acceptable Criminal Offender Record Inquiry (CORI) and Fingerprint results.
I agree to the terms above. Yes No
If signing electronically: Each party agrees that this Agreement and any other documents to be delivered in
connection herewith may be electronically signed, and that any electronic signatures appearing on this
Agreement or such other documents are the same as handwritten signatures for the purposes of validity,
enforceability, and admissibility.
Signature:
Date:
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How do I submit a substitute application? 2. From the Office of Substitute Application Processing: To use this option, complete the attached form and return it by mail, fax, e-mail, or hand to the Office of Substitute Applicant Regardless of your source of nomination, approval, if granted, will be for citywide service.

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