Official SealDepartment of Budget and Management


#17-009009-0020
Supplemental Questionnaire

Last Name
First Name
1

 Please indicate your American Sign Language skill level.

Polite (able to greet and exchange pleasantries; indicate or understand an emergency).
Literate (understands a conversation and can respond).
Fluent (is your native language or can converse in the language if it was your native language).
Do not speak sign language.
2

Please check the position for which you would like to be considered:

Early Childhood Education Dept. -- Birth - 5 years
Elementary Department
Middle School
High School
Reading Specialist
Special Needs/Enhanced Services Program
Technology Education (theatre, media, art)
3

Do you currently hold a Teacher Certification?  If so, from what state?

 

Yes No
4

Have you previously obtained Highly Qualified status from a school district?

Yes No

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