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Teacher Application Form

indicates a required answer

1. *

First name
2. *

Last name
3. *

Street address
4. *

Town
5. *

State
6. *

Phone number
7. *

E-mail address
8. *

Zip code
9. *

Church currently attending
10. *

Do you have a personal relationship with Jesus Christ?

 (1 required)
Yes No
11. *

If so, please briefly state your testimony.  If not, please comment.
12. *

Have you read and agree with the Petra Statement of Faith? 

 (1 required)
Yes No
13. 

 If no, please elaborate.
14. *

Educational background, including highest degree earned.
15. *

Please list the class(es) you would be interested in teaching at Petra.
16. *

Do you in agree with Petra's Handbook and will you comply?

 (1 required)
Yes No
17. 

If you have any concerns regarding Petra's policies,  please elaborate.
18. *

Have you ever been convicted of a crime?

 (1 required)
Yes No
19. 

If yes, please explain each conviction, nature of offense, what led to the conviction, how recently the offense was committed, sentence imposed, and any type of rehabilitation required.
20. *

Teacher signature and date