STANDARD APPLICATION
For Teaching Positions in Pennsylvania Public Schools
(PLEASE PRINT OR TYPE)
POSITION(S) DESIRED Middle Level Math Teacher
NAME Kulp Amy Lee
LAST FIRST MIDDLE PROFESSIONAL PERSONNEL ID
PRESENT ADDRESS 82 Golf Course Road (570)-574-2863
STREET (AREA CODE) TELEPHONE
Hunlock Creek PA 18621
CITY STATE ZIP CODE
PERMANENT ADDRESS 82 Golf Course Road (570)-256-7676
STREET (AREA CODE) TELEPHONE
Hunlock Creek PA 18621
CITY STATE ZIP CODE
E-MAIL ADDRESS (IF AVAILABLE) amy.kulp1@gmail.com
LIST, IN ORDER OF PREFERENCE, THE GRADES, SUBJECTS AND/OR POSITIONS FOR WHICH YOU ARE APPLYING:
1. 8th-7th grade math 2. 6th grade math 3. 5th grade math
CERTIFICATION
(LIST ALL AREAS IN WHICH YOU HOLD VALID PENNSYLVANIA AND/OR OUT-OF-STATE TEACHING CERTIFICATES. NOTE: APPLICANTS HOLDING A CERTIFICATE
FROM ANOTHER STATE MUST OBTAIN A PENNSYLVANIA CERTIFICATE IN ORDER TO TEACH IN PENNSYLVANIA PUBLIC SCHOOLS.)
AREA OF CERTIFICATION ISSUING STATE DATE ISSUED
PA Grades: 4-8: Core PA 7/10/2020
Assessment
PA Grades: 4-8: Sub. Conc: Math PA 11/25/2020
HAVE YOU ACQUIRED TENURE IN PENNSYLVANIA? NO
IF YES, IN WHAT SCHOOL DISTRICT?
DATE AVAILABLE FOR EMPLOYMENT 12/4/2020
IF YOU ARE NOT EMPLOYED FULL TIME, ARE YOU INTERESTED IN BEING PLACED ON OUR SUBSTITUTE LIST? ☐ YES ☐ NO
LONG-TERM ☐ YES ☐ NO SHORT-TERM ☐ YES ☐ NO
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PDE 353A (12/03/13)
EDUCATIONAL BACKGROUND
DIPLOMAS, GRADE POINT
MAJOR/
SCHOOL OR INSTITUTION AND LOCATION DEGREES OR AVERAGE
MINOR
CREDITS EARNED (GPA)
HIGH SCHOOL Northwest Area high School - High School 3.7
Shickshinny PA General Diploma
Education
COLLEGE/UNIVERSITY Wilkes University - Wilkes-Barre PA Middle Bachelor of 3.17
Level Math Arts
/
Psychology
COLLEGE/UNIVERSITY
GRADUATE STUDY
GRADUATE STUDY
EXPERIENCE
(PRESENT OR MOST RECENT FIRST)
Dates Name of Employer and Address Your Title
June Pump N Pantry
From Sales Associate
28, 2017 2375 PA-118
Hunlock Creek PA, 18621
To Present Person-In-Charge
(Area Code) Telephone: 570-477-2054
Work Performed: Reason for Leaving:
- Customer service Currently working
- Sanitation
- Stocking
- Food safety and prep
Name & Title of Susan Garrahan - Manager Final Yearly $14.25 per hour
Supervisor: Salary:
Dates Name of Employer and Address Your Title
January 1, Wilkes University
From Desk Attendant
2018 84 W. South Street
April 29, Wilkes-Barre PA, 18701
To
2020 (Area Code) Telephone: N/A
Work Performed: Reason for Leaving:
- Assisted students who were locked out of rooms Pandemic closed colleges down
Copied and printed materials for RA’s
Assisted in office tasks when needed
Name & Title of Roberta Schaeffer - Resident Life Assistant Final Yearly $12 per hour
Supervisor: Salary:
Dates Name of Employer and Address Your Title
September Wilkes University Panamanian Math
From
2018 84 W. South Street Tutor
December Wilkes-Barre PA, 18701
To
2018 (Area Code) Telephone: N/A
Work Performed: Reason for Leaving:
Repeating math multiplication and division Semester ended
clarifying translation between English and spanish
Guiding students toward correct answer
Name & Title of Mrs. Anne Thomas (retired) - coordinator Final Yearly $12 per hour
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PDE 353A (12/03/13)
Supervisor: Salary:
Please list activities that you are qualified to supervise or coach:
Student government, theatre/performing arts, various clubs, mascot
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If you have not been previously employed in a teaching position, please complete the following:
STUDENT OR PRACTICE TEACHING
GRADE OR SUBJECT TAUGHT NAME AND ADDRESS OF SCHOOL 1. COLLEGE SUPERVISOR
2. COOPERATING TEACHER
6th grade - math and Northwest Area Intermediate School 1. Dr. Dorinda McHenry
social studies 20 Sunset Lake Rd.
Shickshinny, PA 18655 2. Mrs. Amy Kunec
1.
2.
Student Teaching References:
Please attach photocopies of letters of reference and/or evaluations from college/university student
teacher supervisor and cooperating teacher(s).
REFERENCES
References should include superintendents, principals or professors who have first-hand knowledge of
your professional competence and your personal qualifications. Experienced teachers should include the
superintendent and principal of the two most recent schools in which employed. If any person(s) listed
should not be contacted for reference at the present time, indicate in the left-hand margin the date
contact(s) may be made.
NAME POSITION ADDRESS TELEPHONE
Amy Kunec Cooperating WORK: 20 Sunset Lake Road (570)-760-6968
Teacher Shickshinny, PA, 18655
Terry Long Assistant WORK: 2375 PA-118 (570)-592-
Manager Hunlock Creek, PA18621 6087
Sabrina Rios Coworker / HOME: 873 South Franklin St. (570)-592-8501
Teaching Wilkes-Barre PA, 18702
Assistant
OTHER QUALIFICATIONS
Summarize special job-related skills and qualifications acquired from employment or other experiences
(including U.S. military service) and/or state any additional information you feel may be helpful in
considering your application, i.e. honors, awards, activities, technology skills or professional
development activities:
Food safety certified, taught minor coding classes, student taught during pandemic which has given me
an insight on Zoom, google classroom, and how to adapt to online learning.
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Activities: Student Government Class Treasurer (4 years), Bystander Intervention Volunteer (3
years)Rotaract Club Vice President/President (2 years)
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PDE 353A (12/03/13)
GENERAL BACKGROUND INFORMATION
You must give complete answers to all questions. If you answer "Yes" to any question, you must list all
offenses, and for each conviction provide date of conviction and disposition, regardless of the date or
location of occurrence. Conviction of a criminal offense is not a bar to employment in all cases. Each
case is considered on its merits. Your answers will be verified with appropriate police records.
Criminal Offense includes felonies, misdemeanors, summary offenses and convictions resulting from a
plea of "nolo contendere" (no contest).
Conviction is an adjudication of guilt and includes determinations before a court, a district justice or a
magistrate, which results in a fine, sentence or probation.
You may omit: minor traffic violations, offenses committed before your 18th birthday which were
adjudicated in juvenile court or under a Youth Offender Law, and any convictions which have been
expunged by a court or for which you successfully completed an Accelerated Rehabilitative Disposition
program.
Were you ever convicted of a criminal offense? ☐ Yes ☐ No
Are you currently under charges for a criminal offense? ☐ Yes ☐ No
Have you ever forfeited bond or collateral in connection with a criminal ☐ Yes ☐ No
offense?
Within the last ten years, have you been fired from any job for any reason? ☐ Yes ☐ No
Within the last ten years, have you quit a job after being notified that you ☐ Yes ☐ No
would be fired?
Have you ever been professionally disciplined in any state? ☐ Yes ☐ No
Professional disciplined means the annulment, revocation or suspension of
your teaching certification or having received a letter of reprimand from an
agency, board or commission of state government, such as the
Pennsylvania Professional Standards and Practices Commission.
Are you subject to any visa or immigration status, which would prevent ☐ Yes ☐ No
lawful employment?
Note: If you answered "Yes" to any of the above questions, please provide a detailed explanation on a separate sheet of
paper, including dates, and attach it to this application. Please print and sign your name on the sheet, and include
your social security number.
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ACT 34 Clearance (PA State Police Criminal Background Check)
Each applicant must submit with his/her employment application a copy of a Criminal History Record from the
Pennsylvania State Police. Prospective employees must submit ORIGINAL report, which may not be more than
one (1) year old.
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ACT 114 (Federal Criminal History Record)
Each applicant must submit with his/her employment application a copy of a Federal Criminal Record from the
Federal Bureau of Investigation (FBI). Prospective employees must submit ORIGINAL report, which may not be
more than one (1) year old.
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ACT 151 Clearance (PA Child Abuse History Clearance)
Each candidate must submit with his/her employment application a copy of an official clearance from the
Pennsylvania Department of Public Welfare. Prospective employees must submit ORIGINAL report, which may
not be more than one (1) year old.
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ESSAY
Please write an essay as described on page six. For your convenience, you may attach a sheet; however, your
essay may not exceed one page. At the bottom of the attachment, please print and sign your name.
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CERTIFICATION AND RELEASE AUTHORIZATION
I certify that all of the statements made by me are true, complete and correct to the best of my knowledge and
belief, and are made in good faith. I further certify that I am the sole author of the essay. I understand that any
misrepresentation of information shall be sufficient cause for: (1) rejecting my candidacy, (2) withdrawing of
any offer of employment, or (3) terminating my employment.
I hereby authorize any and all of my previous employers and/or supervisors to release any and all of my
personnel records, and to respond fully and completely to all questions that officials of____________ (school
district) may ask regarding my prior work history and performance. I will hold such previous employers and/or
supervisors harmless of any and all claims that I might otherwise have against them with regard to statements
made to this school district. I further authorize these officials to investigate my background, now or in the future,
to verify the information provided and release from liability all persons and/or entities supplying information
regarding my background. However, I do not authorize the production of medical records or other information,
which would tend to actually identify a disability nor do I authorize inquiries which would include information
related to any medical condition or medical history. Further, I do not waive any rights which I may have under
state or federal law related to my right to challenge the disclosure of unlawful or inaccurate information, whether
by the school district or by entities or persons providing such information to the school district, including any and
all claims concerning allegations of employment discrimination because of race, color, sex, religion, national
origin, ancestry, age or disability.
12/2/2020 Amy Kulp
Date Signature of Candidate (in ink)
[Must be original]
Pennsylvania school districts shall not discriminate in their educational programs, activities or employment practices based on race, color, national
origin, sex, disability, age, religion, ancestry or any other legally protected classification. This policy is in accordance with state and federal laws,
including Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Sections 503 and 504 of the Rehabilitation Act of
1973, the Age Discrimination Act of 1975, the Americans with Disabilities Act of 1990 and the Pennsylvania Human Relations Act. Information
relative to special accommodation, grievance procedure, and the designated responsible official for compliance with Title VI, Title IX, and Section 504
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may be obtained by contacting the school district.
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ESSAY
We are interested in your ability to organize and express thoughts on a specific topic in a succinct manner.
Please select one of the following topics and write an essay in the space provided on this page.
1. The Most Important Qualities of an Outstanding Educator.
2. My Philosophy of Student Discipline.
3. The Importance of Continuing Professional Development and How I Plan to Incorporate It Throughout
My Career.
4. Essential Elements of Instruction, Administration or Area of Certification.
5. How Information Technology (i.e., computers, Internet) Can Be Integrated into the Instructional Process
and Curriculum.
It is important to continue professional development as a teacher to help become better educators,
include new technology, and to improve student work. Professional development can help a teacher become a
better educator because they can learn more effective ways to teach or more effective ways to keep students
engaged. It can also provide educators a new view or method that they might have not have heard about before
and can give them that opportunity to try it out. Professional development may also give educators the
opportunity to use and learn about technology that they may not have had the opportunity to do so otherwise.
Ten years ago, nobody would have imagined that every student would have their own laptop or Chromebook.
Four years ago, nobody would have imagined students needing an online classroom to do their work instead of a
physical classroom. Teachers and educators constantly need to be updated with new technology to benefit their
curriculum. Regardless of whether they implement it in class, it is better to have it in your repertoire than not
know how to use it when given it. The last and most important reason that continuing professional development
is so important is to improve student work. Teachers constantly need to reflect on their teaching abilities and
whether how they teach is effective in their classroom. If students are constantly failing while a teacher is using
packet-work, they may want to switch up their technique. Professional development can offer them unique or
different ways to teach their students. It can provide students creative ways to do an assignment, but they can
have fun with it. These are the reasons as to why it is so important to continue professional development as a
teacher. I plan to incorporate professional development throughout my career. I plan on at least taking one
method or activity that I learn about and try to implement it in class. If it does not go well, I probably will not use
it again or I may try again at a later date. If it goes well or if the students seem to respond positively, I would try
using it when it becomes applicable to use.
Signature Amy Kulp Name Amy Kulp
Note to applicants: This application can be downloaded from the Department of Education's home page which is accessible at: http://www.state.pa.us.
This application was developed, in accordance with Section 1204.1 of Act 107 of 1996, by the Pennsylvania Department of Education is consultation with
organizations representing school administrators, including personnel administrators, teachers and school boards. Questions should be referred to PDE
School Services Office at Voice Telephone (717) 787-4860, Text Telephone TTY (717) 783-8445 or FAX (717) 783-6802. If you need accommodation in
PDE-353A (12/03/13)
completing this application, including alternate format, please contact the school district.
PDE-353A (12/03/13)
