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Vincennes Community School Corporation
1712 S. Quail Run Road
Vincennes, IN 47591
(812) 882-4844
Send email to: biblem@vcsc.k12.in.us

APPLICATION FOR CERTIFIED STAFF

Application Date:
Note: This application expires one (1) year after the preceding date. A new application may be submitted at that time.
It is the policy of the Vincennes Community School Corporation that no employee or candidate for a position in this Corporation shall be discriminated against on the basis of race, color, religion, national origin, creed, ancestry, age, sex, marital status or disability.
Name:
Address:

Permanent Address: (if different)

Permanent Phone: (if different) Social Security No.:
Indiana Teacher Retirement Fund No.:
Parent/Spouse's Name :
Are you under contract now? YES NO Date contract expires:
Employer's Name:
Earliest Date Available for Work:
For Position As
(Indicate order of preference)
Elementary Teacher (K-5)
Middle School Teacher (6-8)
High School Teacher (9-12)
Special Education Teacher
Other (Please list)
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