3rd and 4th Grade Elementary School Teacher

New York, NY
Teaching
Full-time

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Mandatory

  • If you were referred to us by a current employee, please input their full name below. If you were not referred by someone, please write N/A below.
  • If you were referred to us by a "Referral - Non-Employee", please enter their full name, email address and phone number below. If you were not referred at all, please write N/A below.
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  • Address Line 2 (i.e. Apt. 4B)
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  • Are you a previous Success Academy employee?
  • Do you have a family or close personal relationship with anyone in the Success Academy Charter Schools' community (includes employees, students, and students' families)?
  • If you answered "Yes" to the question above, please provide the name. If you answered "No" to the question above, please write "N/A".
  • Criminal History: To the best of your knowledge, do you have a pending criminal charge or a criminal conviction in any jurisdiction? Please note that all potential employees will be required to undergo a background check, reference check and clearance of your employment from the New York State Education Department prior to starting. Any offer of employment is contingent upon satisfactory verification of these professional requirements.
  • If you answered "Yes" to the question above regarding Criminal History, please provide each of the following: (1) a brief summary of the conduct that led to the criminal conviction(s) and/or pending criminal charge(s), (2) the current status of the criminal conviction(s) and/or pending criminal charge(s), and (3) any other relevant information, including an explanation of how Success Academy can feel confident that such conduct will not be repeated and will not affect your work with Success Academy. Please note that one or more pending criminal charges and/or criminal convictions will not necessarily bar you from working for Success Academy. However, we strongly prefer to know about such issues in advance of your background check. If you answered "No" to the question above, please write "N/A."
  • Similar Conduct: Have you engaged in any similar conduct that you believe Success Academy should be aware of?
  • If you answered "Yes" to the question above question regarding Similar Conduct, please provide each of the following: (1) a brief summary of the conduct and (2) any other relevant information, including an explanation of how Success Academy can feel confident that such conduct will not be repeated and will not affect your work with Success Academy. If you answered "No" to the question above, please write "N/A."
  • Work Authorization: Are you authorized to work in the United States?
  • If you've answered "No" to the question above ("Work Authorization"), please provide an explanation below. Otherwise, please write "N/A".
  • Visa Sponsorship: Will you now or in the future require sponsorship for employment visa status in order to work for Success Academy Charter Schools? Before your employment begins, we will have to obtain verification of your authorization to work in the United States. Any offer of employment is contingent upon satisfactory verification of this professional requirement.
  • If you've answered "Yes" to the question above ("Visa Sponsorship"), please provide an explanation below. Otherwise, please write "N/A".
  • Do you anticipate doing work for another company or organization (on a paid or voluntary basis) while working at Success (including board memberships)?
  • If you've answered "Yes" to the question above, please elaborate on the nature of this work, including your weekly/monthly responsibilities, the nature of the organization, and your specific role.
  • What is your current academic or work status?
  • What are your salary expectations for a new position?
  • When are you available to start a new position?
  • Do you foresee any conflicts with fulfilling the requirements of a full-time position due to school or other commitments?
  • Did you complete your undergraduate degree?
  • What undergraduate university/college did you attend?
  • Are you a current or former member of Teach For America?

Placement Preferences

  • If there is anything you would like us to know regarding placement please share below.

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  • Do you have a valid NY State certification to teach? If so, what type of certification?

Additional information


U.S. Equal Employment Opportunity information   (Completion is voluntary and will not subject you to adverse treatment)

Success Academy Charter Schools provides equal employment and affirmative action opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability.

Success Academy Charter Schools is a federal contractor or subcontractor subject to certain governmental recordkeeping and reporting requirements for the administration of civil right laws and regulations. Employment decisions are made on the basis of job-related criteria without regard to race, ethnicity, color, religion, sex, sexual orientation, gender identity, marital status, age, genetic information, national origin, disability, military, or veteran status, or any other classification protected by applicable law.

We invite all applicants to voluntarily self-identify their race, ethnicity, and gender. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment. Information obtained will be retained in a confidential file and separate from personnel records. This information may only be used in accordance with the provision of applicable federal laws, executive orders, and regulations. If you want more information about any of the sections, please check with a company representative.


Self-identification of veteran status   (Completion is voluntary and will not subject you to adverse treatment)

Success Academy Charter Schools is a Government contractor subject to the Section 4212 of the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, which requires Government contractors to take affirmative action to employ and advance in employment: (1) Disabled veterans – A veteran who served on active duty in the U.S. military and is entitled to disability compensation (or who but for the receipt of military retired pay would be entitled to disability compensation) under laws administered by the Secretary of Veterans Affairs, or was discharged or released from active duty because of a service-connected disability; (2) Recently separated veteran – A veteran separated during the three-year period beginning on the date of the veteran's discharge or release from active duty in the U.S military, ground, naval, or air service; (3) Active duty wartime or campaign badge veteran – A veteran who served on active duty in the U.S. military during a war, or in a campaign or expedition for which a campaign badge was authorized under the laws administered by the Department of Defense; (4) Armed forces service medal veteran – A veteran who, while serving on active duty in the U.S. military ground, naval, or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985 (61 Fed. Reg. 1209). If you believe that you belong to any of the categories of protected veterans, please indicate by making the appropriate selection.


Self-identification of disability   (Completion is voluntary and will not subject you to adverse treatment)

Form CC-305 / OMB Control Number 1250-0005 / Expires 1/31/2020

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:

  • Blindness
  • Deafness
  • Cancer
  • Diabetes
  • Epilepsy
  • Autism
  • Cerebral palsy
  • HIV/AIDS
  • Schizophrenia
  • Muscular dystrophy
  • Bipolar disorder
  • Major depression
  • Multiple sclerosis (MS)
  • Missing limbs or partially missing limbs
  • Post-traumatic stress disorder (PTSD)
  • Obsessive compulsive disorder
  • Impairments requiring the use of a wheelchair
  • Intellectual disability (previously called mental retardation)
Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Note: Name and date are only required if you filled out Disability status.