GCSD Application For Employment

Application for Employment

Instructions:Each question MUST be filled out and accurately answered. No action can be taken on this application until all questions have been answered. ONE APPLICATION PER POSITION
Applying for:

Classified Position Licensed Position
Job Title applying for:
Personal Information
Legal Name *

First Name Middle Name Last Name
Maiden or Former Name Used

First Name Last Name
Date of Birth *

Month Day Year
Date
Current Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Email Address *
Phone Number *

Area Code Phone Number
Alternate Phone Number

Area Code Phone Number
Emergency Contact
Include Full Name and Phone Number
Date Available to Start

Month Day Year
How did you hear about Gilpin County Schools

District Website Personal Referral Job Posting Walk-In
If referred by a staff member include name and position. If a response to a job posting list the site you saw the posting.
Are you a parent/guardian of a Gilpin County School student *
Child/Children's name and grade
If you are applying for a Licensed Position are you currently licensed

Yes No
In what state(s) are you licensed
Endorsement Area(s)
List Formal Education
Diploma, Bachelors, Masters, Doctorate
Special Trainings (i.e. Languages, Technology)
Include name and date of training
List Professional Experience
List most recent first. Please clarify any gaps in employment.
Personal/ Professional References
List at least four references
Cover Letter *

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Include Philosophy of Education with Cover Letter Cancel of
Resume *

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Upload a copy of your transcripts

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Only upload transcripts from Vocational, College, University etc. Cancel of
Equal Opportunity Employer

Gilpin County School District RE-1 is an equal opportunity educational institution and shall not discriminate on the basis of race, color, creed, sex, sexual orientation (which includes transgender) national origin, religion, age, disability, genetic information, ancestry, marital status, or conditions related to pregnancy or childbirth, or any other applicable status protected by federal, state, or local law. For information regarding civil rights or grievance procedures, contact Superintendent, Gilpin County School District RE-1, 10595 Hwy 119, Black Hawk, CO 80433, 303-582-3444, or contact the Office of Civil Rights, U.S. Department of Education, Cesar E. Chavez Memorial Building, Suite 310, 1244 Speer Boulevard, Denver, CO 80204, 303-844-5695 (Revised April 2018)

Applicant's Oath

Gilpin County School District RE-1 requires all school district applicants to submit a form certifying that the applicant has, or has never been, convicted of a felony or misdemeanor. At the time of employment, the district through the Colorado Bureau of Investigation and/or other law enforcement agencies will conduct a criminal record check. Fingerprints will be submitted to the Colorado Bureau of Investigation and Federal Bureau of Investigation for the purpose of conduction a police criminal background investigation. In the event of any discrepancy between this statement and the results of the investigation, the school district reserves the right to terminate your employment.
I am the above listed applicant and I do herby certify under penalty of perjury, either:
1. HAVE YOU EVER (as a juvenile or an adult) been convicted*; pled nolo contendere (no contest); been placed on probation; enrolled in a pretrial diversion programm or had adjudication withheld in a criminal offense, felony, misdemeanor or otherwise; or are there any criminal charges now pending against you other that a noncriminal traffice viotation?
Yes No
2. Have you ever been involuntarily terminated, asked to resign. or tendered your resignation to avoid termination in connetion with any other employment?
Yes No
3. Are you aware of any facts, which are likely to give rise to a claim by someone that you have behaved immorally or otherwise have affected the health, safety or welfare of children?
Yes No
*"Convicted" means a conviction by a jury or by a Court and shall also include in the forfeiture of any bail, bond or other security deposited to secure appearance by a person charged with having committed a felony or misdemeanor, the payment of a fine, a plea of nolo contendere, and the imposition of a deferred or suspended sentence by the Court.

If your answer is yes to any of the above questions, complete information below.
- Upload a detailed letter of explanation, including the type of misdemeanor or felony, and discussion of other factors, such as the seriousness and nature of the offense the time that has elasped since the date the offense was committed, the nature of the psition for which you seek employment, and evidence of rehabilitation.
- Provide court documents if applicable, verifying the conviction(s)
Be advised that an affirmative answer does not automatically disqualify applicant from consideration for employment. Infomation provided will be considered in making a final employment decision.

I hereby authorize any employer, employee, law enforcement agency, administrator, state agency, institution or private information bureau to provide Gilpin County School District, or any person or gency authorized to request information on behalf of Gilpin County School District, any and all information they might have, personal or otherwise, with regard to any subject which may near upon my fitness for employment.

This authorization to obatin records and information is not intended to permit the release of my medical records, medical information contained in my employment or education records, or information relating to any worker's compenation claims that may have been filed in conjunction with any prior employment, except as my be authorized by federal or state law.

This authorization shall be vaild as long as the application remains active in Gilpin County School District, and if I should become employed by Gilpin County School Distirct, for the duration of such employment. A photographic copy of such authorization shall be as vaild as the original.

I certify that the information furnished on this oath is true and accurate. I understant and agree that any falsification, misrepresentation, misleading statement or omission of fact in either the application or during the pre-hire process will be sufficient reason for my not being offered employment or my immediate dismissal, at any time, if employed. I understand that failure to provide any of the information requested above my prevent consideration of my application.
Use mouse (left-click) or if you have a touch screen use your finger to sign in the box *

Clear
Your electronic signature certifies that the information you provide on this application is accurate and true. By entering your name into the appropriate fields of the online application you are legally signing the document.
Name *

First Name Middle Name Last Name
Please Upload any documentation listed on the Oath if you answered "yes" to any of the questions

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Application for Employment

Personal Information