FACULTY / EMPLOYEE CREATE PROFILE
If you are a first time job seeker to our site, please create a profile by providing
the information below.
Your profile information will only be used to help us identify you for any current or future job opportunities we may have that match your background.

First Name:*

  

Last Name:*

  

Street Address:*

  

City:*

  

State:*

  

Zip:*

  

Country:*

  
Permanent Address (If Different from current)
Permanent Address:  
Permanent City:  
Permanent State:  
Zip Code:  
Permanent Country:  

Phone:

  
Alternate Telephone:  

E-mail:*

  

Alternative E-mail:

  

Gender:*

  

Date of Birth:*

  

Social Security#:

  
Occupation  
Ethnicity:  
If Other Please Specify:  

US Citizen or Green Card Holder:*

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Status:  

Password:*

  

Re-Password:*

  
Education Information & Teaching Certifications
*High School  
*GPA  
*Graduation Date  
* Undergraduate School  
*Degree  
*Major  
*GPA  

*Undergrad Graduation date:

  
*Graduate School  
*Degree  
*Major  
*GPA  

*Grad School Graduation date:

  
Other Degree(s)
*Date Received 		 

If you are certified to teach, please list the state(s) and grades or subjects in which you hold certification

 
Professional Experience & Skills

*How Many years teaching experience do you have?

 
*Where have you taught? (Grade. Subject. Dates )  

*Which Languages are you fluent (verbal and Written) in other than English?

 

*Have you coached a sport?

  

*Please list your extracurricular activities (i.e. instrument, clubs, sports, etc.)

 
What is your Current Salary:  

*Please list all areas you would be interested in teaching.

  
*Which sport(s) would you have an interest in coaching?  

*Which types of independent schools would you like to work (Check all that apply)

  Boys Girls Coed Day schools only
Boarding and/or day schools
*Would you be willing to relocate?   Yes No

*Where would you be willing to relocate?

 

*What are your reasons for leaving your current place of employ?

 

*Which best describes you?

  I am ACTIVELY seeking a teaching opportunity at an independent school
I am PASSIVELY seeking a teaching opportunity at an independent school
*Least Acceptable salary  
*Desired Salary  

Where did you first learn about Montage Diversity Consultants ? (Be Specific)

 
*Have you ever been convicted of a crime?   Yes No
Disposition?
Conviction will not necessarily disqualify for hire 		 

DISCLOSURE STATEMENT

I understand that you may obtain an investigative report in order to enable you to evaluate me as a prospective employee. The investigative report may include information concerning my character, general reputation, personal characteristics, mode of living and financial responsibility and may be obtained through personal interviews with friends, neighbors and associates.

I further understand that I have the right to make a written request to you to learn the complete nature and scope of this investigative consumer report.

I hereby acknowledge that I have read the statement and hereby authorize you to obtain an investigative consumer report as described above if necessary.

*Please list three Professional References:

 

*Please list three Personal References:

 
     
All fields with * are required.  
Montage Diversity Consultants, LLC 1510 Cecil B. Moore Avenue,
Temple Small Business Development Center Incubator, Philadelphia, PA   19121 | 215-921-6349
 © Montage Diversity Consultants 2009. All rights reserved.