Reagan County ISD

Last Name, First Name, Middle Initial

Please enter the date of the application

Used for Certification, reference, and criminal history checks

Please enter the date of the application

Full name of Reference, School District/Firm Name, Position/Title, Phone Number/Email

Employer Name & Location, Position Held, Dates Employed, Supervisors name, Reason for Leaving

Name & Location of Schools Attended, Course of Study & Major/Minor, Diploma, Degree, Certificiate or License Granted, Year of Graduation (College Only)

(including, but not limited to, theft, rape, murder, swindling, and indecency with a minor)

(A felony conviction is not an automatic bar to employment. The district will consider the nature, date, and relationship between the offense and the position for which you are applying.)

I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing the same to you. I understand that the district is required by Texas Education Code to review criminal history of applicants.

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment. This application becomes the property of the district. The district reserves the right to accept or reject it. If you have not received a response during this time period, you may reapply.