Toombs County Schools

TOOMBS COUNTY SCHOOLS

BARRY WALLER, SUPERINTENDENT

117 EAST WESLEY AVENUE, LYONS, GA 30436

Telephone:912-526-3141 Fax:912-526-3291

APPLICATION FOR EMPLOYMENT-AT WILL

DATE:
Last Name	First Name	Middle Name	Maiden Name
Present Address:(Street OR P.O. Box)
City	State	Zip Code
Birthday		Telephone #
Name as it Appears on Social Security Card:

POSITION(S) DESIRED:

Substitute Teacher
Clerical
Registered Nurse
Paraprofessional
Janitor/Maintenance Worker

LOCATIONS(S) DESIRED:

Toombs County High School (9-12)
Toombs Central Elementary (PK-5)
Lyons Upper Elementary (3-5)
Toombs County Middle School (6-8)
Lyons Primary School (PK-2)

EDUCATION: SECONDARY:
High School Attended:
Address (City & State):

CHECK ONE:
High School Diploma Please Attach a Copy of Diploma to this Application.
GED Certification Please Attach a Copy of Certificate to this Application.

COLLEGE OR VOCATIONAL TRAINING:
School Attended	Address	Diploma/Hours

 

EMPLOYMENT RECORD:(Beginning With Most Recent)
Employer	Position Held	Years Employed (i.e. 2001-2003)	Reasons for Leaving

May we contact your present and/or former employer? Yes No

Please indicate by your signature your permission to check your confidential files regarding your past employment record:

Signature

REFERENCE:(Persons not related to your but who have knowledge of your qualifications for the position for which you are applying)

Name:	Phone#:
Position:	Address:
Name:	Phone#:
Position:	Address:
Name:	Phone#:
Position:	Address:

Have you ever been convicted of a felony or any crime involving moral turpitude? Yes No If Yes, Please explain

Are you a retried GA Teacher? Yes No

I understand that any false answer or statement or implication made by me on this application shall be considered sufficient cause for denial of employment.

Signature
Date

THE TOOMBS COUNTY BOARD OF EDUCATION IS AN EQUAL OPPORTUNITY EMPLOYER. THE BOARD DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, SEX, AGE NATIONAL ORIGIN OR HANDICAP IN ITS EDUCATIONAL PROGRAMS, ACTIVITIES, OR EMPLOYMENT POLICIES.

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