teaching application

__________________________________________________________________________________
Derek Urhahn, Superintendent Keenan Kinder, Principal

LEOPOLD R-III SCHOOL DISTRICT
100 Main Street P.O. Box 39
Leopold, MO 63760-0039
Phone: 573-238-2211 Fax: 573-238-9868

APPLICATION FOR NON-CERTIFIED EMPLOYMENT

PERSONAL Date________________________

Name_______________________________________________

Address_____________________________________________ Phone No.____________________

EMPLOYMENT DESIRED

Position______________________________________________ Date you can start_____________

EDUCATION Name of School: Years Attended: Date Graduated:

High School _______________________________ ___________________ ______________

College _______________________________ ___________________ _______________

University _______________________________ ___________________ _______________

FORMER EMPLOYERS:
Month & Year: Name, Address, Phone Number of Emplyer:
From___________ _____________________________________________________________

To_____________ _____________________________________________________________
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From___________ _____________________________________________________________

To _____________ _____________________________________________________________
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From___________ _____________________________________________________________

List any additional experience you may had that may be helpful for the position desired.
___________________________________________________________________________________

___________________________________________________________________________________

Print this application, complete it, and return it with any additional information you desire to:
Superintendent's Office, Leopold R-III School, P.O.Box 39, Leopold, MO 63760-0039

Equal Opportunity Employer