Providence Academy

Employment Application

Please use the Google Chrome web browser for submitting this application.

Applicant Information

Name

Social Security Number

Street Address

City

State

Zip

Home Phone

Cell Phone

Are you 18 years or Older?

Email Address

Desired Employment

Please place a 1-4 in order of desired placement.

Grammar School (K-4th)

Logic School (5th-8th)

Rhetoric School (9th-12th)

Administration

Electives Only (Specify)

List Specific Courses You are Interested in Teaching

Date you can start at Providence Academy?

Education

High School

City

State

Did you Graduate?

Year Diploma Received

College (Undergraduate)

City

State

Did you Graduate?

Year Degree Received

GPA

College (Graduate)

City

State

Did you Graduate?

Year Degree Received

GPA

Past Employment

List below last three employers, starting with the most recent one first.

Current/Former Employer

Are you currently employed?

Name of Present/Last Employer

Address

City

State

Zip

Starting Date

Leaving Date

Job Title

Starting Salary

Ending Salary

May we contact your supervisor

Name of Supervisor

Title

Phone

Description of Work

Reason for Leaving

Former Employers

Name of Present/Last Employer

Address

City

State

Zip

Starting Date

Leaving Date

Job Title

Starting Salary

Ending Salary

May we contact your supervisor

Name of Supervisor

Title

Phone

Description of Work

Reason for Leaving

Background Information

Please list all certifications (education, trade, associations) current or expired that you hold:

Have you ever been convicted of a felony or misdemeanor? (If yes, please explain on a separate document)

Have you ever been accused of, participated in, or been convicted of sexual misconduct?

Have you been terminated with any company or from any position? If yes, please explain.

Please describe any serious illnesses that you currently are experiencing or have experienced in the past that could interfere with your ability to perform the job description.

If you have taught or instructed at a school in the past, have you ever had your contract not renewed for any reason? If yes, please explain.

References

Personal Reference

Name

Email Address

Phone

How Long

Professional Reference

Name

Email Address

Phone

How Long

Professional Reference

Name

Email Address

Phone

How Long

Professional Reference

Name

Email Address

Phone

How Long

Church Membership

Currently At

How Long

Describe Involvement and activities at Church

Church Pastor

Name

Email Address

Phone

How Long

Personal Information

On a separate document, please provide your personal testimony of faith.
PCCA may review any and all public social media profiles.

Please describe your philosophy of Christian Education

How do you promote Christian values in your home

Professional Organizations/Hobbies/Activities

Statement of Faith

Are there any points of the PCCA Handbook which are inconsistent with you? If yes, please explain.

Service Record

Branch of Service

Discharge Date

Rank

Honorable Discharge

If No, please explain

Authorization
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, Falsified statements on this application shall be grounds for dismissal and criminal prosecution. I authorize investigation of all statements contained herein and the references and employers 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 Providence from all liability for any damage that may result from utilization of such information.”

By Checking This Box I Agree to the Above Statement

AUTHORIZATION FOR INVESTIGATIVE REPORT

I understand that Providence Classical Christian Academy, a private K-12 school, will request a criminal background check through National Crime Search, Inc. (NCS). I further understand that neither Providence Classical Christian Academy nor NCS may give out information about me to anyone without my written consent. The report may contain a record of arrests and/or convictions for violations of any federal, state, local statutes or ordinances. I forever release, absolve, and indemnify to the fullest extent allowed by law Providence Classical Christian Academy, NCS, its affiliates, and all providers of information for releasing and obtaining any information arising from any and all sources. I hereby authorize Providence Classical Christian Academy and NCS to obtain a criminal background report.

Full Legal Name

Aliases

Address

City/State

Zip

Date of Birth

SSN

Driver's License #

State Issued

I have read and understand the above statements and hereby give my express permission to complete this investigation.

File Attachments

Please upload file attachments through the respective fields below. Download the Statement of Faith file here.

Resume

College Transcript

Statement of Faith

Student Non-Discrimination Policy
Providence Classical Christian Academy admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities made available to students of the school. It does not discriminate on the basis of race, color, gender, national and ethnic origin in the administration of its educational policies, admissions policies, financial assistance, athletics, or any other school administered programs. Application for Employment Building Leaders for Christ Mail Information to: Providence Academy, P.O. Box 173, Lowell, AR 72745

Staff Non-Discrimination Policy
Providence Classical Christian Academy does not discriminate on the basis of race, color, gender, national and ethnic origin in the administration of its hiring process