SUBSTITUTE TEACHER APPLICATION PROCESS

SUBSTITUTE TEACHER APPLICATION PROCESS
Substitute teacher applicants may sign up at the Sanilac Intermediate School District if they want to sub in
any school district in the county.
The following are requirements:
• Current or Expired Teaching Certificate
or
• Transcript (90 semester hours from an approved 4-year accredited university with a 2.0 average
or better, or 135 hours if the university is on term hours)
If applicant has a current Teaching Certificate (please provide a copy), follow this outline:
To be eligible to sub, an individual must hold a current teaching certificate. This will allow you to sub in
any area. You are allowed to substitute teach in short term assignments of 90 calendar days or less
outside of the grade level and subject area validity of your teaching certificate. Please bring a copy of
your teaching certificate. (We never keep the original teaching certificate in our files).
Please complete or provide the listed forms below and present to the Sanilac ISD for processing.
•
•
•
•
•
•
•
Substitute Teacher Cover Sheet – Name, Address, Phone Number, etc. (Attach resume if
available.)
Teaching Certificate - Copy for ISD file.
Authorization for Release of Fingerprint results to locals.
Application
Waiver Form – Criminal Record – Sign form and indicate whether or not convicted.
Employer Check – Unprofessional Conduct – Sign and indicate name and address of former
employer (2 pages).
Livescan Fingerprint Request Form – State of Michigan and FBI – Form needs to be taken to
the Sanilac ISD/Sanilac Career Center for L-1 Enrollment Services to do a personal fingerprint
scan. Please call (866)226-2952 to make an appointment. A L-1 Enrollment Services staff
member is only at the Sanilac ISD/Sanilac Career Center every other Tuesday.
If applicant does not have a teaching certificate follow this outline:
If you do not have a teaching certificate, and meet the following requirements, we will submit the
application for the 150-Day permit. A $45 fee will be billed from the Michigan Department of
Education for the 150-Day Permit. If the fee is not paid within 60 days, the Michigan Department of
Education will rescind the permit and your name will be removed from the substitute teacher listing until
the permit is paid in full.
•
•
•
•
•
•
•
Substitute Teacher Cover Sheet – Name, Address, Phone Number, etc. (Attach resume if
available.)
Official Transcript – An Official transcript indicating 90 semester hours from an approved 4-year
accredited university with a 2.0 average or better, or 135 hours if the university is on term hours
(Example: Baker College) or a copy of your current or expired teaching certificate.
Authorization for Release of Fingerprint results to locals.
Application
Waiver Form – Criminal Record – Sign form and indicate whether or not convicted.
Employer Check – Unprofessional Conduct – Sign and indicate name and address of former
employer (2 pages).
Livescan Fingerprint Request Form – State of Michigan and FBI – Form needs to be taken to
the Sanilac ISD/Sanilac Career Center for L-1 Enrollment Services to do a personal fingerprint
scan. Please call (866)226-2952 to make an appointment. A L-1 Enrollment Services staff
member is only at the Sanilac ISD/Sanilac Career Center every other Tuesday.
Once the 150-Day Permit is submitted and approved by the Michigan Department of Education, your
name will appear on the State printout, which indicates whether you have paid the $45 fee. If not paid,
"Unpaid Bill-Permit Rescinded" will appear next to your name. The ISD will check to verify this status
and contact you or remove your name from the sub list, if necessary.
FINGERPRINT FORM - State of Michigan and FBI:
In order to complete this form, your Social Security Number and Driver's License number with picture ID is
required. Once the form is complete, please call L-1 Enrollment Services 1-866-226-2952 to make an
appointment (every other Tuesday) at the Sanilac Career Center. Please note that the Sanilac
Intermediate School District has an I.D. Number on each form. Identix requires that you call ahead of
time, to make sure they have someone available to come to the center to do the fingerprint scan for
processing. The cost for the fingerprints to be processed is $49.25. There is also a $13.50 fee charged to
scan in your prints. Total cost is $62.75.
If you had your fingerprints done by the Livescan process at another school district, you may sign
a release to have the sent to the Sanilac ISD.
CAN I FORWARD MY FINGERPRINTS TO ANOTHER SCHOOL DISTRICT IN MICHIGAN?
If fingerprints were done at the Sanilac Intermediate School District, you must sign a release form
indicating that the prints be forwarded to the school district of your choice.
ALL FORMS HAVE BEEN COMPLETED:
Return all forms by mail or in person to:
Sanilac Intermediate School District
Julie Orchard
175 E. Aitken Road
Peck, MI 48466
Once all the paper work has been returned and processed you may want to visit the local school districts
and let them know that you are available. This is optional, but it gives the school a chance to become
familiar with you.
The Sanilac ISD distributes an updated substitute teacher listing to the local school districts on a regular
basis.
If you have any questions, contact the Sanilac Intermediate School district.
Sanilac Intermediate School District
Julie Orchard, Superintendent’s Secretary
Phone: (810) 648-4700, ext. 240
FAX: (810) 648-5784
NEW SUBSTITUTE TEACHER COVER SHEET
2009-2010
NAME: ________________________________________________ DATE: ______________________
ADDRESS: __________________________________________________________________________
CITY, STATE, ZIP_____________________________________________________________________
PHONE NUMBER(S) __________________________________________________________________
DATE OF BIRTH _________________________ SOCIAL SECURITY NO. _______________________
TYPE OF TEACHING CERTIFICATE: _____________________________ EXPIRES: ______________
UNIVERSITY: ________________________________________________________________________
HIGHEST DEGREE: __________________________________________________________________
IF YOU HOLD A CURRENT OR EXPIRED TEACHING CERTIFICATE, LIST ENDORSEMENTS AND
EXPIRATION DATE: (GRADES K-6, 7-8, ALL SUBJECTS, 9-12 MATH, ETC.)
____________________________________________________________________________________
____________________________________________________________________________________
All Applicants:
MAJOR: ____________________________________________________________________________
MINOR: _____________________________________________________________________________
Individuals who hold a valid Michigan Teaching Certificates are not required to have a substitute permit
approval for teaching in short term assignments of 90 calendar days or less outside of the grade level and
subject area validity of their teaching certificates.
Substitute teachers who do not have a teaching certificate must have the 150-Day Permit. We will submit
your name and information to the Michigan Department of Education and the Michigan Department of
Education will send you a bill for $45.00. The 150-Day Permit is only good for the current school year.
Please choose one:
_____ I currently hold a valid Michigan Teaching Certificate. (Please enclose a copy of your Michigan
Teaching Certificate for our files.)
_____ I ask the ISD to apply for a substitute teaching permit for me. I understand that such permit is
valid for 150 days of teaching per academic year. I also understand that upon approval of this
permit the Michigan Department of Education will bill me $45 annually for this permit. (If the fee
is not paid within 60 days, the Michigan Department of Education will rescind the permit and my
name will be removed from the substitute teacher listing until the permit is paid in full.)
I AM AVAILABLE TO SUB AT THE FOLLOWING SCHOOLS:
_____ ALL SCHOOLS
_____ BROWN CITY
_____ CARSONVILLE-PORT SANILAC
_____ CROSWELL-LEXINGTON (Selected candidates will be invited to attend a substitute teacher
workshop held in September and January before they are asked to sub
in Cros-Lex.)
_____ DECKERVILLE
_____ MARLETTE
_____ PECK
_____ SANDUSKY
_____ ISD SPECIAL EDUCATION
_____ SANILAC CAREER CENTER
GRADE LEVEL PREFERENCE:
DAYS AVAILABLE:
MON.
K-6
TUES.
7-8
WED.
9-12
THURS.
STARTING DATE: ____________________________
ALL GRADES
FRI.
ALL DAYS
NEW SUBSTITUTE TEACHER COVER SHEET
2009-2010
NAME: ________________________________________________ DATE: ______________________
ADDRESS: __________________________________________________________________________
CITY, STATE, ZIP_____________________________________________________________________
PHONE NUMBER(S) __________________________________________________________________
(FOR OFFICE USE ONLY)
FINGERPRINT RESULTS AS OF: ____________________________________________________
(State/FBI)
Fingerprint Results Sent to Local School Districts in which individual is available to substitute at:
_____________________
CURRENT TEACHING CERTIFICATE ON FILE: _________________________________________
TRANSCRIPTS: ____________________________
EMPLOYER CHECK: __________ YES
__________ NO
TEACHING CERTIFICATE: _______________________________
EXPIRATION DATE: _____________________________________
FOR OFFICE USE ONLY:
Added to Sub List ________________
Added to Data Base _______________
Billed Permit _____________________
Application Number _______________
Rescinded ______________________
Remove _________________________
TO:
175 East Aitken Road
Peck, MI 48466
Phone: (810) 648-4700
Fax: (810) 648-5784 (Supt.)
Fax: (810) 648-4834
Central Office
 Duane Lange
Superintendent
ext. 241
dlange@sanilac.k12.mi.us
Career-Technical Preparation
 Deborah Wild
ext. 229
Director/
Sanilac Career Center Principal
dwild@sanilac.k12.mi.us
Sanilac Intermediate School District
175 East Aitken Road
Peck, MI 48466
CRIMINAL RECORDS CHECK:
Release Authorization:
I, _________________________________, understand and agree that school districts are
allowed to share criminal records checks required to hire new personnel and hereby
authorize the Sanilac Intermediate School District to share any criminal records check
report from the Michigan State Police and/or F.B.I. with other Michigan school districts and
non-public schools.
Request Verification:
I, _________________________________, was previously fingerprinted on
_________________________ and authorize release of my criminal history records from
_________________________________ School District to Sanilac Intermediate School
District.
__________________________________________
Signature
46 North Jackson Street
Sandusky, MI 48471
Phone: (810) 648-2200
Fax: (810) 648-2275
__________________________________________
Date
Special Education
 Barbara Leveille
ext. 123
Director
bleveille@sanilac.k12.mi.us
Board of Education
 John Tanton, President
 Paul Muxlow, Vice-President
 Brian Mellstead, Treasurer
 Cynthia Nunn, Secretary
 Louise Blasius
 Debi Dhooghe
 Les King
“Recognizing the value and needs of each person, the Mission of the Sanilac Intermediate School District is to
provide leadership and deliver quality educational programs and services to local school districts resulting in
improved learning for all."
SISD Web Site:
www.sanilac.k12.mi.us
It is the policy of the Sanilac Intermediate School District that no person shall, on the basis of religion, race, color, national origin, gender,
handicap, age, height, weight, marital status or disability, be excluded from participation in, be denied the benefits of, or be subject to
discrimination during programs, activities, and employment. Inquiries regarding this policy should be directed to Barb Leveille, Special Education
Director, 46 North Jackson Street, Sandusky, MI 48471 (810) 648-2200.
SANILAC COUNTY SCHOOLS
(BROWN CITY, CARSONVILLE-PORT SANILAC, CROSWELL-LEXINGTON, DECKERVILLE, MARLETTE, PECK,
SANDUSKY AND SANILAC ISD)
SUBSTITUTE TEACHERS'
APPLICATION BLANK
Name in Full _____________________________________________________
Home Address____________________________________________________________________
Street
City
State
Zip
Telephone No.________________
Present Address__________________________________________________________________
Street
City
State
Zip
(If different than home address)
Telephone No.________________
Are you a citizen of this country or do you have legal rights to remain permanently in this
country?
Yes_______________
No________________
Academic and Professional Training
Name of School
Location
Years Attended
Degree or Diploma
Majors
Minors
High School
College
What certificate do you hold to teach in the Public Schools of this State?___________________________________
Date Certificate was issued_________________________
Date Certificate Expires___________________________
Name under which Certificate was granted_____________________________________________________________
Name of School/Employer
Employment/Teaching Experience
Location/
Supervisor
Grade or Subject Taught/Work Performed
Time Period Taught/Worked
(over)
Have you ever been dismissed, asked to resign or refused re-employment as a teacher or substitute?
Yes__________ No__________If yes, explain___________________________________________________
________________________________________________________________________________________
Have you ever been convicted of a felony or misdemeanor other than a minor traffic violation?
Yes__________ No__________If yes, give details_______________________________________________
_____________________________________________________________________________________
Are you presently under arrest for a pending felon charge?
Yes__________ No__________If yes, give details_______________________________________________
________________________________________________________________________________________
State grade and subject area you are interested in substitute teaching in_____________________________
________________________________________________________________________________________
Are you willing to go outside of your certification for substitute teaching?
Yes__________ No__________If yes, please state subject areas you are willing to substitute in____________
________________________________________________________________________________________
________________________________________________________________________________________
Do you currently hold a substitute teaching permit?
Yes__________ No__________If yes, who applied for the permit___________________________________
________________________________________________________________________________________
I HEREBY AUTHORIZE THE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION.
PERMISSION IS GIVEN TO CONTACT REFERENCES AND EMPLOYERS. I UNDERSTAND THAT THIS
APPLICATION WILL BECOME PART OF MY PERMANENT SUBSTITUTE TEACHER FILE AND THAT
ANY MISREPRESENTATION, MISLEADING OR UNTRUTHFUL STATEMENT OR OMISSION IS CAUSE
FOR DISMISSAL AS A SUBSTITUTE TEACHER WITH THE SANILAC COUNTY SCHOOLS (BROWN CITY,
CARSONVILLE, CROSWELL-LEXINGTON, DECKERVILLE, MARLETTE, PECK, SANDUSKY AND SANILAC ISD).
_____________________
Date
______________________________________
Applicant's Signature
It is the policy of the Sanilac Intermediate School District and the Sanilac County Schools (Brown City,
Carsonville-Port Sanilac, Croswell-Lexington, Deckerville, Marlette, Peck and Sandusky) that no person shall, on
the basis of religion, race, color, national orgin, gender, handicap, age, height, weight, martial status or
disability, be excluded from participation in, be denied the benefit of, or be suject to discriminiation during
programs, activities, and employment. Inquiries regarding this policy should be directed to Barb Leveille,
Special Education Director, 46 North Jackson Street, Sandusky, MI 48471 (810) 648-2200.
Sanilac County Schools
Brown City Community Schools
Carsonville-Port Sanilac Schools
Croswell-Lexington Community Schools
Deckerville Community Schools
Marlette Community Schools
Peck Community Schools
Sandusky Community Schools
Sanilac ISD/Sanilac Career Center
_______________________________________________________________________
175 East Aitken Road
Peck, MI 48466
Phone: (810) 648-4700
Fax: (810) 648-5784 (Supt.)
Fax: (810) 648-4834
CONDITIONAL EMPLOYEE STATEMENT:
Pursuant to Public Act 138 of 2005, I, ______________________, represent that (check all that
apply):
Central Office
____ 1.
 Duane Lange
Superintendent
ext. 241
dlange@sanilac.k12.mi.us
I have not been convicted of, or pled guilty or nolo contendere (no contest) or is the
subject of a finding of guilt by a judge or jury of any crime.
____ 2.
I have been convicted of or pled guilty or nolo contendere (no contest) or am the
subject of a finding of guilt by a judge or jury for the following crimes (use separate
sheet to explain nature of conviction, date and court).
_____ Felony _____Misdemeanor
Career-Technical Preparation
 Deborah Wild
ext. 229
Director/
Sanilac Career Center Principal
dwild@sanilac.k12.mi.us
_____________________________________
___________________________________________________________________
_____ Felony _____Misdemeanor
_____________________________________
___________________________________________________________________
_____ Felony _____Misdemeanor
_____________________________________
___________________________________________________________________
In signing this form, I understand and agree that:
46 North Jackson Street
Sandusky, MI 48471
Phone: (810) 648-2200
Fax: (810) 648-2275
Special Education
1.)
If I have been convicted of a listed offense, my employment shall be terminated. I also
understand that if I have been convicted of a felony, other than a listed offense, the
superintendent, or chief administrator and the board or governing body must each
approve, in writing, my employment or work assignment.
2.)
Until the criminal history report is received and reviewed by the employing
school/district, I am regarded as a conditional employee and if the criminal history
report is not the same as my representation(s) above, my employment contract is
voided at the option of the school.
 Barbara Leveille
ext. 123
Director
bleveille@sanilac.k12.mi.us
______________
Date
________________________________________
Signature
Board of Education
 John Tanton, President
 Paul Muxlow, Vice-President
 Brian Mellstead, Treasurer
 Cynthia Nunn, Secretary
 Louise Blasius
 Debi Dhooghe
 Les King
“Recognizing the value and needs of each person, the Mission of the Sanilac Intermediate School District is to
provide leadership and deliver quality educational programs and services to local school districts resulting in
improved learning for all."
SISD Web Site:
www.sanilac.k12.mi.us
It is the policy of the Sanilac Intermediate School District that no person shall, on the basis of religion, race, color, national origin, gender,
handicap, age, height, weight, marital status or disability, be excluded from participation in, be denied the benefits of, or be subject to
discrimination during programs, activities, and employment. Inquiries regarding this policy should be directed to Barb Leveille, Special Education
Director, 46 North Jackson Street, Sandusky, MI 48471 (810) 648-2200.
AUTHORIZATION AND RELEASE FORM
SANILAC INTERMEDIATE SCHOOL DISTRICT
175 East Aitken Road
Peck, MI 48466
Phone: (810) 648-4700
Fax: (810) 648-5784 (Supt.)
Fax: (810) 648-4834
Central Office
 Duane Lange
Superintendent
ext. 241
dlange@sanilac.k12.mi.us
Career-Technical Preparation
 Deborah Wild
ext. 229
Director/
Sanilac Career Center Principal
dwild@sanilac.k12.mi.us
I, _______________________________, the undersigned applicant for
employment with the Sanilac Intermediate School District, authorize my current
and former employer(s) to disclose to the Sanilac Intermediate School District any
information relating to any discipline and/or unlawful, unprofessional, insubordinate
or inappropriate conduct by me and to make available and/or provide copies of all
documents maintained by my current of former employer(s) in my personnel or
other file(s) which relate to such discipline or conduct.
I further agree that I will not take any form of legal action against my current and
former employer(s) and any employee(s) or agent(s) action on their behalf and
hereby release said employer(s) and persons from any liability whatsoever for
disclosing and/or releasing any information or documentation to the Sanilac
Intermediate School District pursuant to this form. Furthermore, I hereby waive
the right to receive any notice, including that required by Section 6 of the BullardPlawecki Employee Right To Know Act, being MCL ≈ 423.506, from my current or
former employer(s) for the disclosure and/or release of information and/or
documentation described in this form.
I understand that Section 1230b of the Michigan Revised School Code, being MCL
≈ 380.1230b, requires the Sanilac Intermediate School District to request
information related to "unprofessional conduct", meaning acts of misconduct; acts
of immorality, moral turpitude or inappropriate behavior involving a minor; or
commission of a crime involving a minor, prior to hiring any applicant and that this
information is covered by this form.
46 North Jackson Street
Sandusky, MI 48471
Phone: (810) 648-2200
Fax: (810) 648-2275
Name and Address of Previous Employer:
Special Education
__________________________________________
 Barbara Leveille
ext. 123
Director
bleveille@sanilac.k12.mi.us
__________________________________________
__________________________________________
Board of Education
 John Tanton, President
 Paul Muxlow, Vice-President
 Brian Mellstead, Treasurer
__________________________________________
Signature
______________
Date
 Cynthia Nunn, Secretary
 Louise Blasius
 Debi Dhooghe
 Les King
“Recognizing the value and needs of each person, the Mission of the Sanilac Intermediate School District is to
provide leadership and deliver quality educational programs and services to local school districts resulting in
improved learning for all."
SISD Web Site:
www.sanilac.k12.mi.us
It is the policy of the Sanilac Intermediate School District that no person shall, on the basis of religion, race, color, national origin, gender,
handicap, age, height, weight, marital status or disability, be excluded from participation in, be denied the benefits of, or be subject to
discrimination during programs, activities, and employment. Inquiries regarding this policy should be directed to Barb Leveille, Special Education
Director, 46 North Jackson Street, Sandusky, MI 48471 (810) 648-2200.
SANILAC INTERMEDIATE SCHOOL DISTRICT
175 EAST AITKEN ROAD
PECK, MICHIGAN 48466
810-648-4700
PREVIOUS EMPLOYER CHECK
Name of Candidate:
_________________________________________________
Address:
_________________________________________________
_________________________________________________
Name & Address
Previous Employer:
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Date of Previous Employment: ___________________________________
(FOR OFFICE USE ONLY)
Is there documented evidence in the candidates' personnel file that
may relate to unprofessional conduct.
__Yes
__No
If yes, please forward any documentation to the attention of:
Sanilac Intermediate School District
Attention: Superintendent
175 East Aitken Road
Peck, Michigan 48466
______________________________
Signature Previous Employer
Thank you for your cooperation in this matter!
___________
Date
PHONE: 1-866-226-2952
LIVESCAN FINGERPRINT REQUEST
Date fingerprinted: ____________
Type of picture ID presented: __________
APPLICANT INFORMATION
Must provide a picture ID to be printed
Applicant Name ____________________________________________________
Last
First
Date of Birth _______________
Middle
Race _______________
Sex _____________
Applicant Address ___________________________________________________
City, State __________________________________________ Zip ____________
Applicant Phone Number ______________________________________________
REQUESTING AGENCY INFORMATION
Agency ID:
3242P
Agency Name: Sanilac Intermediate School District
(RQID)
Reason fingerprinted: (select only one)
SE
- School Employment, mcl 380.1230
$49.25 + $13.50 = $62.75
CPE - National Child Protection Act, NCPA employee
$49.25
CPV - National Child Protection Act, NCPA volunteer
$45.25
**Disclaimer: Any and all fingerprints processed with incorrect fingerprint codes/reasons, etc are
the responsibility of the REQUESTING AGENCY. MSP will charge for second requests due to
incorrect fingerprint reason. **
Total Fee for fingerprinting is $62.75.
($30.00 for MSP, $19.25 for FBI prints and $13.50 Processing Fee)
Payment must be made by certified check or money order made payable to L-1
Enrollment Services.
You may schedule your appointment by calling (866) 226-2952 or by going to their
website at www.l1enrollment.com.
Substitute Teacher Quick Reference
CONTACT PERSON
SCHOOL
PHONE NUMBER
Robin Kennedy
Joe Sutherland
Tammy Wagester
Brigette Reifert
Lisa Fritch
Anne Redman
Sandy Schneidewind
Shelly Bullis
Barb Kohn
Carolyn Pardy
Kellie Paehlig
Brown City
CPS Elementary
CPS MS/HS
Cros-Lex
Deckerville
Marlette
Peck Elementary
Peck High School
Sandusky
Sanilac Career Center
Sanilac ISD Special Ed.
810-346-2781 ext. 5102
810-657-9393 ext. 201
810-657-9394 ext. 100
810-679-1024
810-376-3875 ext. 306
989-635-7427
810-378-5200 ext. 3100
810-378-5200 ext. 3200
810-648-3400 or 810-648-3040
810-648-4700 ext. 234
810-648-9020 ext. 403
DISTRICT
Brown City
ARRIVAL
8:05 a.m.
8:15 a.m.
K-6
7-12
DISMISSAL
3:10 p.m.
3:05 p.m.
Carsonville-Port Sanilac
8:10 a.m.
8:10 a.m.
8:10 a.m.
Elementary
Middle School
High School
3:10 p.m.
3:00 p.m.
3:00 p.m.
Croswell-Lexington
8:30 a.m.
8:30 a.m.
8:30 a.m.
8:10 a.m.
8:10 a.m.
Meyer
Frostick
Geiger Early Childhood Center
Middle School
High School
3:20 p.m.
3:20 p.m.
3:20 p.m.
3:00 p.m.
3:00 p.m.
Deckerville
8:20 a.m.
8:25 a.m.
Elementary
High School
3:12 p.m.
3:12 p.m.
Marlette
8:15 a.m.
8:10 a.m.
Elementary
Junior / Senior High School
3:10 p.m.
3:14 p.m.
Peck
8:00 a.m.
8:10 a.m.
Elementary
High School
3:05 p.m.
3:05 p.m.
Sandusky
7:55 a.m.
7:50 a.m.
7:50 a.m.
Elementary
Middle School
High School
3:25 p.m.
3:20 p.m.
3:20 p.m.
Sanilac Career Center
8:00 a.m.
Special Education
8:10 a.m.
8:05 a.m.
3:00 p.m.
Elementary
Middle School
Please arrive 15 minutes early!
3:20 p.m.
3:05 p.m.