Auxiliary Employee Application

Namerequired

First Name

M.I. (optional)

Maiden (optional)

Last Name

Date of Birthrequired

Must contain a date in M/D/YYYY format

Social Security Numberrequired

Mailing Addressrequired

Email Addressrequired

Phone Numberrequired

Position Information

Position(s) You are Applying Forrequired

Type of EmploymentrequiredPlease select up to 1 choice

Full-Time

Part-Time

Summer Only

Please select up to 1 choice

Date You Can Begin Workrequired

Must contain a date in M/D/YYYY format

Education/Training

Check the Highest Level of Education Attained:requiredPlease select up to 1 choice

Please select up to 1 choice

Other Training or Education:

Education Backgroundrequired

Name/location of schools, course of study, diploma degree, certification or license, graduate year.

Are you interested in becoming a certified teacher?

Yes

No

Work Experience

Please provide a complete list of all positions you have held in the past 10 years. List the most recent first. Attach additional documents or a resume if possible.

Work Experiencerequired

Employer/location, position/title, dates employed, and reason for leaving.

Resume or Additional Documents (If Applicable)

Attach up to 1 file with a maximum size of 10MB

No file chosen

Special Skills

List specific skills and any machines or equipment you can operate.

Do you have a relative who serves on the Greenville ISD Board of Education?required

Yes

No

If yes, please provide the relative's name and relationship.

References

Please list references the district can contact regarding your work history. Please include all managers and supervisors who evaluated or supervised your performance at your last two employers.

Please List References Belowrequired

Include full name of reference, school district or company name, position/title, email and phone.

Applicant/Contractor Consent & Authorization to Retain Fingerprints

The Department of Public Safety (DPS) and Federal Bureau of Investigation (FBI) retain fingerprints to provide notification to agencies of future events to the criminal history record at the state and national level. In order for each applicant to participate in the Fingerprint-based Applicant Clearinghouse of Texas (FACT) and "Rap Back" (notification services), please have each applicant provide the following information.

Certificationrequired

I certify that all information I provided in relation to this criminal history record check is true and accurate. I authorize the Texas Department of Public Safety (DPS) to access Texas and Federal criminal history record information that pertains to me and disseminate that information to the designated agency with which I am or am seeking to be employed or to serve as a volunteer, through the DPS Fingerprint-based Applicant Clearinghouse of Texas and as authorized by Texas Government Code Chapter 411 and any other applicable state or federal statue or policy, including 28 U.S.C. 534 and 34 U.S.C. 41101.

I authorize the Texas Department of Public Safety to submit my fingerprints and other application information to the FBI for the purpose of comparing the submitted information to available records in order to identify other information that may be pertinent to the application. I authorize the FBI to disclose potentially pertinent information to the DPS during the processing of this application and for as ling hereafter as many be relevant to the activity for which this application is being submitted. I understand that the FBI may also retain my fingerprints and other applicant information in the FBI's permanent collection of fingerprints and related information, where all such data will be subject to comparisons against other submissions received by the FBI and to further disseminations by the FBI as may be authorized under the Privacy Act of 1974. I understand my fingerprints will be searched by and against civil, criminal and latent fingerprints in the Next Generation Identification (NGI) system. I understand I am entitled to obtain a copy of any criminal history record check and challenge the accuracy and completeness of the information before a final determination is made by the relevant agency. I also understand the agency may deny me access to children, the elderly, or individuals with disabilities until the criminal history record check is completed. If a need arises to challenge the FBI record response, you may contact the agency that submitted the information to the FBI, or you may send a written challenge request to the FBI's Criminal Justice Information Services (CJIS) Division at FBI CJIS Division, Attention: Correspondence Group, 1000 Custer Hollow Road, Clarksburg, WV 26306.

Have you ever been convicted of, plead guilty or no contest to, or received probation, suspension or deferred, adjudication for a felony or offense involving moral turpitude (including, but not limited to, theft, rape, murder, swindling, or indecency with a minor)?required

Yes

No

Have you ever been convicted of, admitted committing, or are you awaiting trial for any crime (excluding only minor traffic violations not involving any allegation of drug or alcohol impairment?) Yo must answer "YES" even if the matter was later dismissed, deferred, vacated, or expunged. If you answer "YES," you must provide dates of the proceedings, the court where the proceedings occurred, a statement of the accusation against you, and the final disposition of the case(s). required

Yes

No

Have you ever been dismissed (fired) from and job, or resigned at the request of your employer, while charges against you or an investigation of your behavior was pending? You must answer "YES" even if the matter was later resolved with any form of settlement or severance agreement, regardless of the terms. If you answer "YES," you must provide the date of termination of employment, the name, address, and telephone number of the employer(s), and a statement of the alleged reasons for termination, resignation, or allegations against you. required

Yes

No

Have you ever had any license or certificate of any kind (teaching certificate or otherwise) revoked or suspended, or have you in any way been sanctioned by, or is any charge complaint now pending against you before any licensing, certification, or other regulatory agency or body, public or private? If you answer "YES," you must provide the dates of proceedings, name, address, and telephone number of the agenda or body where proceedings took place, a statement of the accusations against you, and the final disposition.required

Yes

No

Are you now being investigated for any alleged misconduct or other alleged grounds for discipline by any licensing, certification, or other regulatory body (teacher certification or otherwise) by your current or any previous employer? If you answer "YES," you must provide the name, address, and telephone number of the employer or licensing body and a statement of the accusations against you. required

Yes

No

Have you ever been found guilty of, entered a plea of nolo contendere (no contest) or been arrested for, been charged with, or are you awaiting trial for any felony or misdemeanor offense under Federal, State, or Tribal law involving crimes of violence; sexual assault; molestation; exploitation; contract or prostitution; crimes against persons; or offenses committed against or involving children? You must answer "YES" even if the matter was later dismissed, deferred, vacated or expunged. If you answer "YES" you must provide dates of proceedings, the court where the proceedings occurred, a statement of the accusation(s) against you, and the final or current disposition of the matter. required

Yes

No

If you answer "Yes" to ANY questions above, use the space below to. explain. For criminal charges, specify all the charge(s), date(s), disposition(s), name(s) and address(es) of the court(s) and judgement(s) or conviction(s).

Charge:

Date

Must contain a date in M/D/YYYY format

Disposition/Comments:

Verificationrequired

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentation or omissions of face may be grounds for rejection of my application or dismissal from subsequent employment.

I authorize the references listed to give you and an all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing the same to you.

I understand the the district is authorized by the Texas Education Code 22.083 to obtain criminal history record information on applicants the district intends to employ.

This application becomes the property of the district. The district reserves the right to accept it or reject it.

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In This Section

Position Information

Education/Training

Work Experience

References

Applicant/Contractor Consent & Authorization to Retain Fingerprints

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Links & Resources