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Full Name (First M.I. Last)
Date (mm/dd/yyyy)
Street Address
City, State
Zip Code
Phone
Email
Date Available (mm/dd/yyyy)
Social Security No.
Date of Birth (mm/dd/yyyy)
Are you a citizen of the United States? ---Yes, I am a U.S. Citizen.No, I am not a U.S. Citizen.
If no, are you authorized to work in the U.S.? ---Yes, I am authorized to work in the U.S.No, I am not authorized to work in the U.S.
If yes, explain.
Education
High School Dates Attended (yyyy–yyyy)
Did you Graduate? YesNo
College Dates Attended (yyyy–yyyy)
What Degree did you earn?
Any other education?
References
Please list three professional references.
Reference No. 1 Full Name
Relationship
Company
Address
Reference No. 2 Full Name
Reference No. 3 Full Name
Previous Employment
Supervisor
Job Title
Salary (Starting to Ending)
Responsibilities
Duration of Time there (mm/yyyy to mm/yyyy)
Reason for Leaving
May we contact your previous supervisor for a reference? ---Yes, you may contact my previous supervisor.No, you may not contact my previous supervisor.
Duration of time there (mm/yyyy to mm/yyyy)
Teaching Information
Musical Experience
Teaching Experience
Primary instrument(s) you teach
Secondary instrument(s) you teach
Which level(s) are you comfortable teaching? BeginnerIntermediateAdvanced
Which style(s) are you comfortable teaching? ClassicalSuzukiJazzGospelOther
Which age(s) are you comfortable teaching? 4–6 years old7–12 years oldTeenAdult
Location(s) you want to teach
Days Available to Teach (Mark all possible) MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Times Available to Teach (Mark all possible) 9–12 AM12–3 PM3–6 PM9–9 PM
Mobile Music Teachers Position
Please describe why you would like this teaching position (1 to 2 paragraphs)
Please email a resume to leann@mobilemusicteachers.com in addition to this application.
Disclaimers, Permissions, and Assertions
I certify that my answers are true and complete to the best of my knowledge. If this application leads to association, I understand that false or misleading information in my application may result in my release. By typing my name below, I authorize the verification of the information provided on this form as correct. Signature