Education Consultant Application

Education Consultant Application

Center of Excellence for Educator Preparation and Innovation
Purpose: This form serves as an application for employment with the Center of Excellence for Educator Preparation and Innovation.
Date*

MonthDayYear
Date
YesNo
List the position you are applying for here.*
I have carefully reviewed the position description and understand the duties & responsibilities. I meet the qualifications outlined.*
Name*

HonorificFirst NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Email Address*
example@example.com
Cell Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Gender*
Ethnicity*
Race*
Citizenship*
YesNo
YesNo
Include a copy of your unofficial transcript from your most recent or advanced degree for initial processing. NOTE: If selected, an official transcript will be required from the college/university where you earned your most advanced degree.*

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YesNo
Provide a copy of your SC Teaching Certificate.

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Years of professional teaching/administrative experience*
Employer*
Why are you interested in employment with the Center of Excellence for Educator Preparation and Innovation?*
If selected for the role, I have confirmed my service to the EPI Center poses no conflict with my current employment.*
I am interested in*
Job Title*
District Affiliation (if applicable)
Current School
Current Teaching Assignment. Choose NA if not currently teaching.*
YesNo
YesNo
BillboardCollege FairFriend or RelativeMagazineNewspaperRadioTVOther
If "Other", please explain.*
YesNo

List the name, contact information (phone & work email), and current job title for one of two required professional references. Briefly indicate their relationship to you.

Rows	Professional Reference
Name
Phone Number
Email Address
Current Job Title
Relationship

List the name, contact information (phone & work email), and current job title for one of two required professional references. Briefly indicate their relationship to you.

Rows	Professional Reference
Name
Phone Number
Email Address
Current Job Title
Relationship

Is there anything else you would like us to know?
Attach the following: A cover letter.*

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Attach the following: A resume or curriculum vitae.*

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Attach the following: A descriptive summary outlining your skills and abilities to achieve the duties described.*

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Attach the following: A single page listing of the complete contact information for three professional references who can be contacted at any time.*

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I certify that the information I am submitting is accurate to the best of my knowledge.I give the Center of Excellence for Educator Preparation and Innovation permission to contact references and verify any of the information provided, as needed. I understand that misrepresentation or omission of facts relevant to this application will be sufficient cause for rejection of this application. Further, I understand this is an independent application with the Center of Excellence for Educator Preparation and Innovation and NOT an application for employment with Voorhees University or any affiliate entity.
Signature*

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