STANDARD APPLICATION

For Teaching Positions in Pennsylvania Public Schools

(Please Print or Type)

Position(s) Desired Special Positions Coordinator

Name Hidbrader Lauren ***-**-****

Leigh

Last First Middle Social Security Number1

Present Address 815 Kocher Dr. 724-***-****

Street (Area Code) Telephone

Grove City PA 16127

City State Zip Code

Permanent Address same

Street (Area Code) Telephone

City State Zip Code

E-mail Address (if available) abkken@r.postjobfree.com

List, in order of preference, the grades, subjects and/or positions for which you are

applying:

1. Special Ed. (all 2. Elem. Ed. 3.

grades)

CERTIFICATION

(list all areas in which you hold valid Pennsylvania and/or out-of-state teaching

certificates. Note: Applicants holding a certificate from another state must obtain

a Pennsylvania Certificate in order to teach in Pennsylvania Public Schools.)

Area of Certification Issuing State Date Issued

Elementary Education PA 8/2004

Special Education PA 8/2004

Have you acquired tenure in no

Pennsylvania?

If yes, in what school district?

Date available for employment 08/2010

If you are not employed full time, are you interested in being Yes No

placed on our Substitute List?

Long-term

[1]

EDUCATIONAL BACKGROUND

School or Institution and Major/ Diplomas, Grade Point

Location Minor Degrees or

Credits Average

Earned (GPA)

High School Slippery Rock High School general diploma 3.4

College/Universit Slippery Rock University El. Ed. certificate 3.1

y

College/Universit Slippery Rock University Special certificate 3.1

y Ed.

Graduate Study Baker Center for Graduate MBA 5 credits 3.9

Studies

Graduate Study

EXPERIENCE

(Present or most recent first)

Dates Name of Employer and Address Your Title

From 8/2009 Mercer Area School District-YES Academy Emotional

Support Teacher

Mercer-Greenville Rd.

To present Mercer, PA

(Area Code) 724-***-****

Telephone:

Work Performed: Reason for Leaving:

All areas of teaching including but not I would like to pursue full time status

limited to curriculum and lesson

planning and assessment, behavior

modification, development,

implementation, and evaluation of IEPs,

and fostering developmentally

appropriate skills in students.

Also involved in daily collaboration

with program staff as district liason

between school district and program

staff.

Name & Title Michelle Dietrich Final 25,000

of Yearly

Supervisor: Salary:

Dates Name of Employer and Address Your Title

From 1/2007 Crossroads, Inc teacher

1243 Roemer Ave.

To 8/2008 Farrell, PA 16121

(Area Code) 724-***-****

Telephone:

Work Performed: Reason for Leaving:

All areas of teaching including but not Laid off due to budget cuts

limited to curriculum and lesson

planning and assessment, behavior

modification, development,

implementation, and evaluation of IEPs,

and fostering developmentally

appropriate skills in students.

Name & Title Alex Giroski Final 30,000

of Yearly

Supervisor: Salary:

Dates Name of Employer and Address Your Title

From 8/2004 Diversified Family Services Supervisor

3679 E. State St

To 2/2005 Hermitage, PA 16138

(Area Code) 724-***-****

Telephone:

Work Performed: Reason for Leaving:

Supervision of staff and clients, staff Left position fto pursue teaching career

scheduling and training,

tracking client services, scheduling

and organization of meetings and

activities, establishing communication

and fostering relationships with

community organizations, assessment and

continuous monitoriing of client

strengths and needs.

Name & Title Lana Smith Final 24,000

of Assistant Program Supervisor Yearly

Supervisor: Salary:

Please list activities that you are qualified to supervise or coach:

track

softball

cheerleading

If you have not been previously employed in a teaching position, please

complete the following:

STUDENT OR PRACTICE TEACHING

Grade or Subject Name and Address of School College Supervisor

Taught Cooperating Teacher

l 1.

2.

1.

2.

Student Teaching References:

Please attach photocopies of letters of reference and/or evaluations from

college/university student teacher supervisor and cooperating teacher(s).

REFERENCES

References should include superintendents, principals or professors who

have first-hand knowledge of your professional competence and your personal

qualifications. Experienced teachers should include the superintendent and

principal of the two most recent schools in which employed. If any

person(s) listed should not be contacted for reference at the present time,

indicate in the left-hand margin the date contact(s) may be made.

Name Position Address Telephone

Michelle Dietrich Director of Mercer Elementary 724-***-****

Special Mercer, PA

Education

Chuck Ferrainolo Counselor Mercer-Greenville Rd. 724-***-****

Mercer, PA

Ann Stillwagon Teacher Enterprise Rd. 724-***-****

Grove City, PA

Amy Fierst Teacher 1243 Roemer Ave. 724-***-****

Farrell, PA

OTHER QUALIFICATIONS

Summarize special job-related skills and qualifications acquired from employment

or other experiences (including U.S. military service) and/or state any

additional information you feel may be helpful in considering your application,

i.e. honors, awards, activities, technology skills or professional development

activities:

Throughout college, I supplemented my studies by working full time in a

residential facility assisting mentally and physically disabled individuals. I

feel that this experience is invaluable to my professional growth as an educator

in that I learned many fundamental skills in a hands-on manner and had the

opportunity to practice my knowledge in a constantly changing and intereactive

environment. I was fortunate to later have the opportunity to focus more on

assessment of needs and strengths of individuals while overseeing direct care,

providing me with a wide knowledge base regarding learning and developmental

processes. Additionally, employment as a teacher in various alternative education

environments provided me with experience in the development and implementation

of IEPs, as well as extensive knowledge of behavioral plans as the majority of my

students have required academic as well as emotional support services. Through

this experience I have increased my knowledge of behavioral and mental health

issues common to students as well as techniques to lessen the negative effects on

learning due to such obstacles.

GENERAL BACKGROUND INFORMATION

You must give complete answers to all questions. If you answer "Yes" to

any question, you must list all offenses, and for each conviction provide

date of conviction and disposition, regardless of the date or location of

occurrence. Conviction of a criminal offense is not a bar to employment in

all cases. Each case is considered on its merits. Your answers will be

verified with appropriate police records.

Criminal Offense includes felonies, misdemeanors, summary offenses and

convictions resulting from a plea of "nolo contendere" (no contest).

Conviction is an adjudication of guilt and includes determinations before a

court, a district justice or a magistrate, which results in a fine,

sentence or probation.

You may omit: minor traffic violations, offenses committed before your

18th birthday which were adjudicated in juvenile court or under a Youth

Offender Law, and any convictions which have been expunged by a court or

for which you successfully completed an Accelerated Rehabilitative

Disposition program.

Were you ever convicted of a criminal offense? Yes No

Are you currently under charges for a criminal offense? Yes No

Have you ever forfeited bond or collateral in connection Yes No

with a criminal offense?

Within the last ten years, have you been fired from any Yes No

job for any reason?

Within the last ten years, have you quit a job after being Yes No

notified that you would be fired?

Have you ever been professionally disciplined in any Yes No

state?

Professional disciplined means the annulment, revocation

or suspension of your teaching certification or having

received a letter of reprimand from an agency, board or

commission of state government, such as the Pennsylvania

Professional Standards and Practices Commission.

Are you subject to any visa or immigration status, which Yes No

would prevent lawful employment?

Note: If you answered "Yes" to any of the above questions, please provide a

detailed explanation on a separate sheet of paper, including dates, and attach it

to this application. Please print and sign your name on the sheet, and include

your social security number.

ACT 34 COMPLIANCE (Background Check of Prospective Employees)

Each Pennsylvania resident must submit with his/her employment

application a copy of a report of Criminal History Record Information

from the Pennsylvania State Police or a statement from the Pennsylvania

State Police that the State Police Central Repository contains no such

information relating to that person. Each out-of-state applicant must

submit with his/her application for employment a copy of a federal

criminal record history from the Federal Bureau of Investigation. The

criminal record history report must be no more than one (1) year old.

The applicant MUST submit the ORIGINAL report prior to employment.

ACT 151 (PA Child Abuse History Clearance)

Each candidate must submit with his/her employment application a copy of

an official clearance statement obtained from the Pennsylvania Department

of Public Welfare or a statement from the Department of Public Welfare

that no record exists. The clearance statement must be no more than one

(1) year old. The applicant MUST submit the ORIGINAL report prior to

employment.

ESSAY

Please write an essay as described on page six. For your convenience,

you may attach a sheet; however, your essay may not exceed one page. At

the bottom of the attachment, please print and sign your name.

CERTIFICATION AND RELEASE AUTHORIZATION

I certify that all of the statements made by me are true, complete and

correct to the best of my knowledge and belief, and are made in good

faith. I further certify that I am the sole author of the essay. I

understand that any misrepresentation of information shall be sufficient

cause for: (1) rejecting my candidacy, (2) withdrawing of any offer of

employment, or (3) terminating my employment.

I hereby authorize any and all of my previous employers and/or

supervisors to release any and all of my personnel records, and to

respond fully and completely to all questions that officials

of____________ (school district) may ask regarding my prior work history

and performance. I will hold such previous employers and/or supervisors

harmless of any and all claims that I might otherwise have against them

with regard to statements made to this school district. I further

authorize these officials to investigate my background, now or in the

future, to verify the information provided and release from liability all

persons and/or entities supplying information regarding my background.

However, I do not authorize the production of medical records or other

information, which would tend to actually identify a disability nor do I

authorize inquiries which would include information related to any

medical condition or medical history. Further, I do not waive any rights

which I may have under state or federal law related to my right to

challenge the disclosure of unlawful or inaccurate information, whether

by the school district or by entities or persons providing such

information to the school district, including any and all claims

concerning allegations of employment discrimination because of race,

color, sex, religion, national origin, ancestry, age or disability.

6/1/2010

Date Signature of Candidate (in ink)

[Must be original]

Pennsylvania school districts shall not discriminate in their educational

programs, activities or employment practices based on race, color,

national origin, sex, disability, age, religion, ancestry or any other

legally protected classification. This policy is in accordance with

state and federal laws, including Title VI of the Civil Rights Act of

1964, Title IX of the Education Amendments of 1972, Sections 503 and 504

of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975,

the Americans with Disabilities Act of 1990 and the Pennsylvania Human

Relations Act. Information relative to special accommodation, grievance

procedure, and the designated responsible official for compliance with

Title VI, Title IX, and Section 504 may be obtained by contacting the

school district.

ESSAY

We are interested in your ability to organize and express thoughts on a specific

topic in a succinct manner. Please select one of the following topics and write

an essay in the space provided on this page.

The Most Important Qualities of an Outstanding Educator.

My Philosophy of Student Discipline.

The Importance of Continuing Professional Development and How I Plan to

Incorporate It Throughout My Career.

Essential Elements of Instruction, Administration or Area of Certification.

How Information Technology (i.e., computers, Internet) Can Be Integrated into the

Instructional Process and Curriculum.

My philosophy of student discipline has been developed through a variety of

experiences that have shaped my perspective of the essential components to

creating and managing the classroom environment. I have learned that students

need structure, a basic routine, and consistency to best reduce negative student

behavior and promote a positive learning environment. Students should play an

integral role in establishing the rules by which they agree to abide; I am

always surprised to learn that the consequences they choose for themselves are

often much more harsh than what I felt would be reasonable. When students

understand the expectations of the classroom as well as consequences which are

enforced consistently, it reduces the students' natural curiosity to limit-test

therefore minimizing classroom distractions. I am also a strong proponent for

delegating responsibilities of the classroom to the students as appropriate for

age level and ability. By individualizing tasks, students feel a sense of

importance and strive to do that task well. I believe that high motivational

levels in the classroom also have a direct correlation on student discipline, and

have practiced many ways to promote student motivation. Some have been

successful for me; others have just cost me a lot of money and taught the

students that they only had to do well enough to earn a reward. I have found that

although verbal praise is generally very effective in managing student behavior,

the best motivator is encouraging the students to compete with themselves while

encouraging each other. Group activities are wonderful for encouraging teamwork

and unity in the classroom, increasing student motivation, and often, problem

solving.

In my experiences, these ideas can be successfully implemented into nearly every

classroom to create a positive learning environment, increasing motivation and

positive behaviors, and developing students' self-esteem thus promoting a safe

and risk-free classroom in which all students can learn.

Signatur Name

e

Note to applicants: This application can be downloaded from the Department of

Education's home page which is accessible at: http://www.state.pa.us.

This application was developed, in accordance with Section 1204.1 of Act 107 of

1996, by the Pennsylvania Department of Education is consultation with

organizations representing school administrators, including personnel

administrators, teachers and school boards. Questions should be referred to PDE

School Services Unit at Voice Telephone 717-***-****, Text Telephone TTY (717)

783-8445 or FAX 717-***-****. If you need accommodation in completing this

application, including alternate format, please contact the school district.

[1] Federal Privacy Act [5 U.S.C. 552A NOTE] Statement. Authority for

requesting social security account numbers: Public School Code of 1949 [24

P.S. 12-1212, 24 P.S. 1224] Principal Purpose: To verify certification.

Other Purposes: Identification and collection of criminal/disciplinary

records for certified educators. Disclosure: Mandatory. Failure to

provide the Social Security Number will result in an applicant not being

considered for employment.

Contact this candidate