Ipswich Subsutitute Teacher Application

Please complete the form below. Required fields marked with an asterisk *

Today's Date*

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Contact Information

First Name*

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Last Name*

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Email 1*

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Mobile Phone*

Number Required

Current Address

Street Address

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City

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Zip/Postal

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Certification*

Certificate or license currently held

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None

Valid South Dakota Teacher Certification

Valid Other State

Other:

Please place a checkmark in the schools or areas that you would be interested in subbing:*

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Ipswich Elementary

Ipswich Middle School

Ipswich High School

Deerfield Colony School

Pembrook Colony School

Rosette Colony School

Special Education Classrooms

Have you ever convicted of or pleaded guilty or no contest to a felony or offense involving moral turpitude ( including, but not limited to, theft, rape, murder, swindling, or indecency with a minor)?

Answer Required

Yes

Please check the box as an affirmation of your understanding of the following:

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I understand that a background investigation will be conducted to verify the authenticity and completeness of the information furnished by me. This background check paperwork must be completed prior to the 1st day of substituting within the district.

The Ipswich Public School District 22-6 does not discriminate in its employment policies, or in its educational programs, on the basis of race, color, creed, religion, age, gender, marital status, disability, national origin, or ancestry.

Office for Civil Rights

US Department of Education

One Petticoat Lane

1010 Walnut St, 3rd Floor, Ste 320

Kansas City, MO 64106

Ph# 816-268-0550

Fx# 816-268-0599

TDD# 800-877-8339

Email: [email protected]

Please fix the highlighted areas below before submitting.

Ipswich Subsutitute Teacher Application