AESOP SUBSTITUTE REGISTRATION - WESD

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Year __________

AESOP SUBSTITUTE REGISTRATION

READ CAREFULLY AND COMPLETE BOTH SIDES OF FORM

NAME

SOCIAL SECURITY NUMBER

MAILING ADDRESS

BIRTH DATE

CITY/STATE/ZIP

EMAIL

PHONE

CHECK THE DISTRICT(S) IN WHICH YOU WILL SUBSTITUTE

The following districts are on our automated system ? AESOP. Please check the districts you would like to work in. You are required to fill out timesheet, Form I-9 and a W-4 for each district you work for. (Please bring ID as specified on the list of appropriate identification documents that is on page 5 of the I-9 Form).

Amity Cascade Dallas Dayton

Falls City

Gervais Jefferson Mt. Angel N. Santiam

Perrydale Silver Falls St. Paul Willamina

WESD PROGRAMS In order to work for WESD programs you will need additional paperwork:

WESD application, Emergency Contact Form and W-4. Every program requires its own time sheet - Classified staff must complete and turn in a timesheet in order to get paid.

RESIDENTIAL PROGRAMS

Linn Co. JDEP - Albany Lord High School/ MacLaren Marion Co. JDEP - Center St. Robert Farrell School/ Hillcrest

EI/ECSE PRESCHOOL

Marion Polk Yamhill

Behavioral Programs

FACILITIES/ CUSTODIAL

Marion Polk Yamhill

OASIS - Dallas OASIS - Brooks OASIS - Yamhill

To qualify as a substitute for WESD Programs acknowledge your compliance by writing your initials here _____.

QUALIFICATIONS

Y N Y N Y N Y N

Are you able to perform the essential functions of this job safely and efficiently? Do you have a High School Diploma or GED? Are you 18 years of age or older? Are you authorized to work in the United States?

Spanish: Other: Sign Language:

Speak Speak

Read Read

Write Write Language: _____________________

CLASSIFIED ONLY

Check the box next to the areas in which you are qualified and willing to substitute.

Courier Crossing Guard Custodial Maintenance Library Media Mail Room Office Assistant

Instructional Assistant Regular Instructional Assistant Special Education

Behavior Program - Special Education Food Service (Must have Food Handler's card) Expiration Date___________ Child Care (Child Care Registry Required) Expiration Date: ____________

MANDATORY TRAININGS: ALL substitutes are required to complete a number of online trainings every year. You should receive an e-mail from the sub desk with the link to the web site, your user name and your password within two weeks of registering or during the month of July you're a current substitute. You will have 30 days to complete all trainings from the date the e-mail is sent. Please note that this user name and password is completely separate from Aesop.

REGISTRATION TIMES AND LOCATION:

Tuesdays 10 AM-12 PM

WESD Marion Center

2611 Pringle Rd SE Salem, OR 97302

PHONE: 503-540-4433

I,

(Print first and last name)

Give permission for Willamette Education Service District (Willamette ESD) to obtain or release information to all schools or employees associated with AESOP, the Willamette ESD Substitute System.

I certify that all information submitted in this registration form, or in any document submitted by me to Willamette ESD is true and complete and that I have not knowingly withheld, nor will I withhold, any information. I understand that my registration does not constitute as an offer for employment.

_______________________________________________________________________ Signature

_______________ Date

This release form is valid for the entire term of service with Willamette ESD unless specified otherwise. Types of information exchanged are Fingerprint Verification, Criminal History Verification and Personal Information.

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