Online Interview

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	First Name
	Last Name
	Address
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Employment History

Current Employer:
Current Position:
Previous Employer:
Previous Position:

Education:

How many years of education have you completed? High School Some college or training 2-Year Degree 4-Year Degree

Have you been or are you currently certified to teach in a state? Yes No

Experience:

How many years of experience do you have working with children? New to field or less than 1 year Atleast 1 but less than 3 yrs. Atleast 3 but less than 5 yrs. Atleast 5 but less than 10 yrs. More than 10 years

Do you have any experience working with Special Education students? Yes No

Do you have any experience working with any of the following categories of Special Needs Children? Mentally Impaired Emotionally Impaired Autistic Physically Disabled Learning Disabled More than one listed above None of the above

Do you have any experience working in a Resource Room? Yes No

Have you ever worked with the Special Olympics? Yes No

Have you ever worked in a Group Home? Yes No

Do you have experience utilizing multi-media or other instructional technology either in a classroom and/or distance learning environment? Yes No

Do you have experience as a Teaching Assistant in a regular classroom setting? Yes No

Do you have experience working in a multicultural environment? Yes No

How much experience do you have working with parents? Very little Some experience High level of experience

Are you passionate about working with children? Yes No

Do you have training in early childhood education? Yes No

Work/Salary:

What type of employment are you willing to accept? Full time Part time Substitute position Temporary Any

General:

Are you currently employed? Yes No

Are you at least 16 years of age and eligible to work in the United States? Yes No

Are you at least 18 years of age and eligible to work in the United States? Yes No

Would you relocate to another state? Yes No

If extended an offer of employment, when would you be available to begin work? Immediately 1 to 2 weeks 3 to 4 weeks Start of the next school year

Are you bi-lingual or multi-lingual? Yes No

In addition to English, in which language are you most fluent? Spanish French Italian German Russian Chinese Japanese Other None

Would you consent to pre-commencement testing, if required, including drug screening, medical testing and/or skill-related testing? Yes No

Would you consent to pre-employment background checks, if required, including past employment information, education verification, and/or reference checks? Yes No

How many miles from your home are you willing to travel to work? Up to 5 miles Up to 10 miles Up to 20 miles Over 20 miles

Are you now or have you been a member of the United States Military, National Guard or Reserves? No I am a Veteran of the United States military I am currently a member of the United States military I am currently a member of the National Guard or Reserves I was a member of the National Guard or Reserves

Please take a moment to briefly share any additional information about yourself that you feel a prospective employer would like to know. We do not recommend pasting of resumes or cover letters.
Additional Info:

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