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POSITION DESIRED
(Check appropriate box.  You may check more than one.) (If you have any professional licenses or certifications, describe them below.):
Clerical/Secretarial          Teacher Aide/Special Education Teaching Certificate     Type   Certificate #  
Custodian                       Health Aide/Registered Nurse Endorsements   / / /  
Maintenance                   Substitute Teacher Illinois Teacher Aide Approval?      Number   
School Bus Driver           Homebound Tutor Registered Professional Nurse       License #    
Commercial vehicle license       License #:  Certified Nursing Assistant (or EMT)    Certificate #   
Other  Other Professional License 

APPLICANTS FOR PERMANENT POSITION:  Would you be willing to sub until a suitable position is available?       Yes         No

WORK SCHEDULE (Check every box that applies to you)
I AM APPLYING FOR:    Permanent Position       Substitute Position     Full-time     Part-time     School Year     12-month
PART TiME (Indicate times you are available) :   Before School      Lunchtime     Morning till noon    Noon till 4:00     After school
SUBSTITUTES:       Check days you are NOT available to work       M              T             W             TH              F
CUSTODIANS:        Are you willing to work nights?   Yes   No        Are you willing to work weekends?   Yes    No

SUBSTITUTE TEACHERS, HOMEBOUND TUTORS, AND TEACHER AIDES PLEASE RESPOND TO THE FOLLOWING QUESTIONS
CIRCLE GRADE LEVEL PREFERRED (You may check more than one)         Early Childhood (special needs)         PKP-K            1-2             3-4              5-8
Are you able to work with a wheelchair bound child?  Yes    No          Can you attend to the personal care needs of a disabled child?  Yes    No
Check areas your training enables you to teach or tutor       PE       Music       Art       Library/LC       LD/BD/EMH         Math        Science        Social Studies        Language Arts

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