Energized for STEM Academy

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NOW ACCEPTING APPLICATIONS FOR THE 2016-2017 SCHOOL YEAR for Middle School Grades 6th - 8th and High School Grades 9th - 12th
Employment Form

Mandatory fields marked *

Personal Data
  1. Can you, after an offer of employment, submit verification of your legal right to work in the US?

    Veteran's priority - A veteran qualifies for a veteran's employment priority if the veteran served in the Army, Navy, Air Force, Marine Corps, Coast Guard of the U.S., or in an auxiliary service of those branches,

    • - Or served in the military for not less than 90 consecutive days during a national emergency declared in accordance with the federal law,
    • - was honorably discharged
    • - and is found to be equally qualified with other applicants.

    Do you qualify for this priority?

    If employed, employee will be asked to provide documents to support qualifications (DD214).
    No one convicted of any felony or misdemeanor involving moral turpitude will be considered for employment with Energized For Stem, Inc.

    Colleges/Universities Attended Dates Attended
    (From - To)
    Graduation Date Degree Major/Subject

















  2. I am also interested in being a substitute.
    I am only interested in being a substitute.
Employment Data

Student-Teaching Information (attach college placement file if recent graduate)

  1. Work and/or Teaching Experience: Please provide a complete listing of all work/teaching positions you have held. Begin with most recent. Please attach listing of other employers, if applicable.



    From/To (Month/Year) Name of Company/School Address, City, State, Zip Name/Title of Supervisor Telephone Number Work Performed Reason for leaving

    Have you ever been employed by Energized for STEM Academy, Inc. organization?
    Under what name? Date:

    I hereby give you permission to complete a reference from furnished by Energized for STEM Academy to release the form with recommendations.

    I certify that the above information is true, accurate and complete. I understand that any misrepresentation or willful omission of fact shall be sufficient cause for disqualification of this application from further consideration or termination of employment.

  2. ENERGIZED FOR STEM ACADEMY, INC.STATEMENT OF NONDISCRIMINATION: It is the policy of our Academynot to discriminate or engage in harassment on the basis of race, color, national origin, sex, religion, age, disability, or any other legally protected status in its educational and vocational programs, services oractivities or matters related to employment as required by Title VI and Title VII of the Civil Rights Act of 1964, as amended; Title IX of the Education Amendments of 1972; Age Discrimination in Employment Act; Americans with Disabilities Act, as amended; and Section 504 of the Rehabilitation Act of 1973, as amended.Inquiries regarding the Academy’snon-discrimination policies in the following areas should be directed to: Argentina M. James, Director of Human Capital at 713.641.1630 or ajames11@houstonisd.org