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Divine Mercy Chinese Association |
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Teacher's Application Form
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| 1. Postion you are applying for: ________________ (Mandarin Teacher/Culture
Teacher) |
2. Name: __________________________________ ____________________________
Last First
Middle
In Chinese |
3. Address: ________________________ __________ _________ ________________
Number Street
City
State
Zip |
| 4. Home Phone: ( )________________ Work Phone: (
)____________________ |
| 5. Laguage in which you are fluent: _____ English _____Mandarin ____other
(list):_____ |
| 6. Other Skills: __________________________________________________________ |
| 7. Social Security #: _______________ California Driver License #:
________________ |
8. Have you ever been convicted of any violations of law?
(Please be truthful. Exclude traffic violations under
$50.00)
Yes_____ No_____ If yes, please explain:_________________________________
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9. Teaching or Related Experience
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School
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Subject
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Starting Date
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Ending Date
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10. Education and Training
High School: ________________________
Location: _________________
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Colleges/Universities Attended
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Date
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Major
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Degree/Unit
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Certification of Applicant: I certify that all statements made in this
application are true,
and I agree and understand that misstatements or omissions of materials
facts may
forfeit my rights to any service in Divine Mercy Chinese Association. |
_______________________ _________________
Signature
Date
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Note: Please bring a sample of your teaching plan for review at the interview.