LBSD Online Application

Official Position

Street Address

Phone Number

Long Beach School District Employment Application

LBSD

Online Employment Application for Certified Staff

Please complete and submit the online employment application. Notification will be sent to you when the application has been processed. You may contact Beth Cuevas for additional information at 228-864-1146 or email her at cuevasb@lbsdk12.com. Thank you for your interest in the Long Beach School District.


Last Name		First Name		Middle Name		Maiden Name


Present Street	Present City		State		Zip		Phone


Permanent Street	Permanent City		State		Zip		Phone


Email			Position Desired

Under Graduate Education

School Attended	Start Date	End Date	Degree Received	Major Subject	Major Credit Hours






Graduate Education
School Attended	Start Date	End Date	Degree Received	Major Subject	Major Credit Hours



Teaching Experience

Name of School District	Street Address	City	State	Zip	Hire Date	End Date	Grade Taught	Subject Taught	Reason for Leaving





References

Professional Information

The following information must be answered.
1. Have you taken the complete battery of National Teacher's Examination?	yes no
2. If yes, date taken.
3. Score on Core Battery
4. Score on specialty area
5. Do you hold a valid (current) Mississippi Teacher's Certificate?	yes no
6. If yes, in what area(s) are you endorsed to teach?
7. Certificate(s) held in other States
8. Please identify the following which you are able to direct successfully: Debates, Singing, School Plays, Oratorical Contests, Clubs, Orchestras, Football, Track, Baseball, Tennis, Physical Education, Playground Activities, Piano, Band, School Paper, others.
Attach a resume listing any additional information you wish to submit.
MS CERTIFICATE: PLEASE FAX A COPY OF YOUR CERTIFICATE TO (228)863-3196-ATTN: KAY PARKER

Personal Data

1. Have you ever been asked to resign, been discharged, or failed to be reemployed for a teaching or administrative position?	yes no
2. If yes, give the name of the District, the date, and reasons for the termination.
3. Have you ever been arrested or convicted of a felony?	yes no
4. If yes, please explain.
5. Have you ever been arrested or convicted of a misdemeanor?	yes no
6. If yes, please explain.
7. Are you presently under contract with any school system?	yes no
8. If yes, school System
9. Are you a citizen of the United States?	yes no
10. Have you ever been a member of the Public Employees Retirement System of Mississippi?	yes no
11. If yes, please list the name of agency
12. Are you currently receiving retirement through PERS?	yes no