USD 309 South Hutchinson

Application for Substitute Teachers


U.S.D. 309 does not discriminate on the basis of sex, race, color, national origin, handicap or age in admission or access to, or treatment, or employment in its programs or activities. Any questions regarding U.S.D. 309’s compliance with Title VI, Title IX, or Section 504 including information about the existence and location of services, activities, and facilities that are accessible to and useable by disabled persons may be directed to the Business Manager, who can be reached at (620)663-7141, 4501 W. Fourth St., Hutchinson, KS 67501, or to the Superintendent of U.S.D. 309.
First Name
Last Name

Address:
City State Zip
Phone:

List grade levels or subject areas preferred:

Are you available for assignments longer than one or two days? Yes No
Please list any grade, subject or school assignment in which you would not be interested: (If you are not interested in substituting at the high school or at a particular grade level, please indicate so we will not call you for the assignment.)

Level and endorsements on certificate you hold

Expiration Date


Highest Degree Held:
From what College
Degree Date:
Education (Include high school, college, graduate work and summer sessions in order taken.):
School Name:
Location:
Semester Credit Hours:
Degree or Diploma:
Major:

School Name:
Location:
Semester Credit Hours:
Degree or Diploma:
Major:

School Name:
Location:
Semester Credit Hours:
Degree or Diploma:
Major:

School Name:
Location:
Semester Credit Hours:
Degree or Diploma:
Major:

Teaching Experience Record:
School Name:
School Location:
Dates:
Number of Years:
Number of Teachers:
Nature of work (If grades, specify what grade and subjects. If high school, the subjects taught & any extra curricular work.):


School Name:
School Location:
Dates:
Number of Years:
Number of Teachers:
Nature of work (If grades, specify what grade and subjects. If high school, the subjects taught & any extra curricular work.):


School Name:
School Location:
Dates:
Number of Years:
Number of Teachers:
Nature of work (If grades, specify what grade and subjects. If high school, the subjects taught & any extra curricular work.):


School Name:
School Location:
Dates:
Number of Years:
Number of Teachers:
Nature of work (If grades, specify what grade and subjects. If high school, the subjects taught & any extra curricular work.):


School Name:
School Location:
Dates:
Number of Years:
Number of Teachers:
Nature of work (If grades, specify what grade and subjects. If high school, the subjects taught & any extra curricular work.):


School Name:
School Location:
Dates:
Number of Years:
Number of Teachers:
Nature of work (If grades, specify what grade and subjects. If high school, the subjects taught & any extra curricular work.):


Professional References
Name:
Occupation:
Address:
Telephone:

Name:
Occupation:
Address:
Telephone:

Name:
Occupation:
Address:
Telephone:

Please provide any additional information which you believe would be helpful in evaluating your qualifications as a substitute teacher.

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