Horizons Teacher Application 2022-2023
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Email *
Applicant Information
Name (Last, First): *
Street Address: *
Phone: *
E-mail address: *
Campus at which I am interested in working: *
Days available: *
Required
I am available to begin working (enter date): *
Are you a citizen of the United States of America? *
If no, are you authorized to work in the U.S.?
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Education
High School - Please include location, attendance years and graduation date. *
College- Please include location, attendance years, graduation date and degree received. *
References
Please list 3 professional references- include name, relationship, company and contact information.
Permission for SLED Background Check and Child Abuse Prevention Assurance Form
Full Legal name: *
Social Security Number:
Date of Birth: *
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Gender: *
I give my permission for east Point Academy and the South Carolina Public Charter School District to conduct criminal backgrounds checks of local, state and national law enforcement databases as a condition of my position with East Point Academy. *
In addition, I, ___________, certify that I am not now nor have I been in the past, the subject of an investigation pertaining to accusations or allegations or charges against me of child abuse, child neglect, or sexual abuse, harassment or exploitation of a child.  (Please type your full name if you certify the statement.)
I have not been found guilty or convicted of any violation of law other than a traffic ticket: *
If you answered "yes" to the above questions, provide explanation:
Disclaimer and signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release from the offered position.

Notice: East Point Academy does not discriminate on the basis of race, gender, disability, age, religion, immigrant status, or national origin in its educational programs and employment practices. All statements provided on this form, my application and references are true and accurate with full disclosure by me of all information pertinent to positions in a K-12 educational setting.
Please initial for application submission and agreement to disclosure: *
Submission Date: *
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