Employment Application

*First Name:

Middle Name:

*Last Name:

*Street Address:

*City:

*State:

*Zip:

*Primary Phone:

Secondary Phone:

*Email:

Pre School Teacher or Asst

Elementary School Teacher (K-5)

Middle School Teacher (6-8)

High School Teacher (9-12)

Foreign Language Teacher:

List Language(s)

Special Education Teacher/Specialist:

List Field(s)

Media Specialist

Teaching Assistant

Administration/Staff Position:

List Specific Position

Other:

List Position

*Preferred status

Part Time

Full Time

*Expected Salary

Annual or Hourly amount

Name of Institution

Location

City & State

Dates Attended

Degree Date

Level of Degree/Diploma

GPA

Name of Institution

Location

City & State

Dates Attended

Degree Date

Level of Degree/Diploma

GPA

Name of Institution

Location

City & State

Dates Attended

Degree Date

Level of Degree/Diploma

GPA

Please lists additional education and experience details in comments section.

*Are you certified to teach? If yes, please list field(s) of certification and confirm if certificate is current or expired:

*List foreign language(s) speak:

Ex: Spanish, Chinese

*List computer skills, including software expertise:

List relevant qualifications and accomplishments:

*Tell us why you're interested in working for Pinecrest Academy?

*How did you hear about this position?

Comments from this section:

Each of the following questions must be answered with a "yes" or "no". If any answer is "yes" please provide explanation in the comment box for this section.

*Have you resigned or been discharged from any position, including armed forces, while under suspicion of having engaged in criminal, immoral, or unprofessional conduct, or are you now under investigation of any such charge?

Yes or No

*Have you ever been investigated for any act of alleged discrimination of any kind including: discrimination on account of race, color, gender, religion, age, national origin, or disabling conditions?

Yes or No

*Have you ever been accused or investigated for a crime of child abuse or physical abuse?

Yes or No

*Have you ever been investigated for allegations of sexual harassment?

Yes or No

Comments from this section:

*Name of Reference #1:

*Relationship to Reference:

coworker, supervisor etc

*Reference Place of Work:

*Reference Phone Number:

Name of Reference #2:

Relationship to Reference:

Reference Place of Work:

coworker, supervisor etc

Reference Phone Number:

All applicants should email their resume to careers@pinecrestacademy.org. By typing your electronic signature below, you hereby certify that all answers are true to the best of your knowledge and agree to have any statements checked by Pinecrest Academy. You understand that any misrepresentations contained herein or in conjunction with the application process may be cause for dismissal.

*Electronic Signature:

Type name to certify all information is accurate

Pinecrest Academy

955 Peachtree Parkway
Cumming, GA 30041
Phone: 770.888.4477
Fax: 770.888.0404
info@pinecrestacademy.org