For HRO use only

Date Received:

Last Name:
CNMI PUBLIC SCHOOL SYSTEM
HUMAN RESOURCES OFFICE

CERTIFIED EMPLOYMENT APPLICATION

Cover Page

LIST OF DOCUMENTS TO ATTACH TO THIS APPLICATION

1. High School Diploma/College Degree

2. Official Transcript (Original) from a U.S. accredited college or

university.
**If Non- U.S. degree accredited see No. 7 below

Date: Expiration:
3. Valid CNMI State Board of Education (Teaching, Counseling,
Librarian) Certificate

First Name:
4. Resume

5. Original Police Clearance from place of residence for the last six (6)
months.

6. Pass PRAXIS II Content Knowledge Test (“Pass” means meeting

CNMI cut score or higher).

7. Transcript Evaluation results from any NACES member (National

Association of Credential Evaluation Services). For Non-USA
Accredited degrees only – see attachment after page 11.

8. Verification of Employment (From previous employers including

dates of employment and position title)

9. Medical Certificate (upon hire)

10. Other: MI:

*** ALL APPLICATIONS WILL BE KEPT FOR 180 DAYS ONLY

To expedite a review of your employment application, you must submit the above required
documents.

Human Resources Office will NOT PROCESS any incomplete applications.

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 POLICY OF NONDISCRIMINATION
Public School System (“PSS”) is an equal opportunity employer dedicated to a policy of
nondiscrimination in employment upon any basis, including a person’s sex, sexual
orientation, race, color, religion, national origin, age, disability, or retaliation for the
exercise of any these rights. In reading and answering the following inquiries, please
keep in mind that none of the questions are intended to imply any limitations, illegal
preferences, or discrimination based upon any information that is not job-related.
This application will be given complete consideration, but its receipt does not imply that
you will be employed. Please fill it out completely and do not alter it. You must also
submit a resume with this application.

APPLICATION FOR CERTIFIED EMPLOYMENT

PERSONAL DATA

Name Social Security No.

Current Address: ____________
Street Address/Box Number City State Zip
Permanent Address:
(Leave blank if the same as your current address)
E-mail Address:__________________________________________________________
Daytime Phone at Which You Can Be Reached: ( )

Evening Phone at Which You Can Be Reached: ( )

Are you a CNMI Government retiree? Yes No

POSITION(S) APPLIED FOR:____________________________________________

Type of Work Desired: Full Time Part Time Temporary (check one)

Salary Desired: $ per (monthly/year/hour)

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GENERAL INFORMATION

1. Have you ever applied for a job with PSS in the past? Yes No
If yes, please give the date of application and the position
for which you applied. Please include any name changes, if
applicable.

2. Have you ever been employed by PSS in the past? Yes No

If yes, please give dates of employment, and position(s) held.
Please include any name changes, if applicable.

3. If hired, will you able to work during the usual hours Yes No
and days required for the position(s) for which you are applying?
If no, explain on a separate sheet of paper and attach.

4. Do you have any commitments to another employer that Yes No

might affect your employment with PSS? If yes, explain on a
separate sheet of paper and attach it.

5. If hired, can you furnish proof that you are 18 years of age Yes No
or older? If no, explain on a separate sheet of paper and attach it.
6. If hired, can you furnish proof that you are eligible to work Yes No
in the Commonwealth of the Northern Mariana Islands as a
resident worker (U.S. citizen, national, spouse of a U.S. citizen
or national, or Compact of Free Assn. citizen)?
If no, please indicate your citizenship:

7. Do you have a teaching certificate? Yes No

If not, state whether you expect to be awarded one and when.

8. Have you ever had any adverse action or any disciplinary Yes No
action with regard to your teaching certificate or employment
in any teaching capacity taken or proposed against you?
If yes, explain on a separate sheet of paper and attach it.

9. Do you have any language abilities (such as reading or speaking

a language other than English) that might help you perform the job(s) Yes No
for which you are applying?
If yes, explain on a separate sheet of paper and attach it.

10. Have you ever been convicted, pled guilty, or pled Yes No
“no contest” to any felony or misdemeanor?
Note: a “yes” answer does not automatically disqualify
you from employment since the nature of the offense, the
date it was committed, and the type of job for which you
are applying will be considered.
If yes, explain on a separate sheet of paper and attach it.

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11. Have you been charged with a crime that has not yet resulted
in a plea of guilty or no contest by you, a trial, or a dropping of the
charge. Note: a “yes” answer will not automatically disqualify you Yes No
from employment . If yes, explain on a separate sheet of paper
and attach it.
12. Have you received a copy of the Regulations for the Public
School System Employment of Certified Personnel? Yes No

13. EMPLOYMENT HISTORY

PRESENT & FORMER EMPLOYERS

(List Most Recent First)
MAY CONTACT YOUR PRESENT EMPLOYER. _____Yes _____NO

1. Company Name Job Title & Duties

Address Dates of Employment From To

City, State, Zip Reason for Leaving

Supervisor ( Name, phone number and email) Your Name When Employed, If Different From Present Name

2. Company Name Job Title & Duties

Address Dates of Employment From To

City, State, Zip Reason for Leaving

Supervisor (Name, phone number and email) Your Name When Employed. If Different From Present Name

3. Company Name Job Title & Duties

Address Dates of Employment From To

City, State, Zip Reason for Leaving

Supervisor (Name, phone number and email) Your Name When Employed, If Different From Present Name

4. Company Name Job Title & Duties

Address Dates of Employment From To

City. State, Zip Reason for Leaving

Supervisor (Name, phone number and email) Your Name When Employed, If Different From Present Name

5. Company Name Job Title & Duties

Address Dates of Employment From To

City, State, Zip Reason for Leaving

Supervisor (Name, phone number and email) Your Name When Employed, If Different From Present Name

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Please Account for Any Time You Were Not Employed After Leaving School in the Past Ten Years.
(You need not list any unemployment periods of one month or less.)

Time Period(s) Reason(s) for Unemployment

IF YOU WERE UNABLE TO LIST ALL PAST JOBS OR PERIODS OF UNEMPLOYMENT ON THIS FORM, PLEASE ATTACH
ADDITIONAL INFORMATION ON A BLAJ\’K SHEET OF PAPER.

14. EDUCATIONAL DATA

SCHOOLS NAME OF SCHOOL and DID YOU DEGREE/ GRADE MAJOR

ATTENDED LOCATION GRADUATE? DIPLOMA/ POINT COURSES
(HIGHEST GRADE YES NO CERTIFICATE AVERAGE OF STUDY
COMPLETED)
HIGH SCHOOL(S) DO NOT DO NOT
ANSWER ANSWER
TECHNICAL,
BUSINESS
OR MILITARY
TRAINING
COLLEGE OR
UNIVERSITY
GRADUATE
SCHOOL
ADDITIONAL JOB-RELATED SEMINARS, SHORT COURSES, WORKSHOPS, OR OTHER EDUCATIONAL
EXPERIENCES:

15. MILITARY EXPERIENCE

A. Have you served in the U.S. military? Yes No

B. If so, list the branch and highest rank obtained:

C. Dates: From to

D. Discharge: Honorable other (explain)

16. REFERENCES: LIST THREE INDIVIDUALS WHO ARE NOT FORMER

EMPLOYEES OR RELATIVES

NAME ADDRESS PHONE OCCUPATION E-MAIL

NUMBER

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17. Please add any additional information (except that which identifies your race, sex,
age, religion, national origin, disability or other non-related personal information) that
you think may be relevant to a decision to hire you.

IMPORTANT

Representation That Application Is Filled Out Truthfully:

By my signature placed below, I confirm that the information provided in this
employment application and accompanying resume is true and complete, and I
understand that any false information or significant omissions may disqualify me from
further consideration for employment, and may be justification for my dismissal from
employment if discovered at a later date.
Date: __________________ Signature: __

Consent to Investigate Criminal Records – Agreement to Notify PSS of Crime:

I authorize the CNMI Public School System’s investigation of all statements contained
in this application and accompanying resume. I understand that this investigation will
include obtaining a police clearance from the CNMI Department of Public Safety, if
applicable, and a record of arrests and dispositions from the Federal Bureau of
Investigation. I also agree to notify the PSS within fifteen days if I should be charged or
convicted of any crime, while my job application is pending or, if hired, during my period
of employment.
Date:___________________ Signature:

Consent to Review License/Credential Records & NASDTEC Records:

I authorize the CNMI Public School System’s investigation of all statements contained
in this application and accompanying resume by reviewing the records of any state
licensing authority under which I currently am, or formerly was, licensed and any record
of employment history available from the National Association of State Directors of
Teacher Education and Certification Clearing House.
Date:____________________ Signature:

Consent to Review Employment Records:

I authorize the CNMI Public School System (PSS) to contact my present employer
(unless otherwise noted in this application form), past employers, past and present co-
workers, listed references and review any records of my past or present employment
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(unless this form indicates that the present employer is not to be contacted) that PSS finds
relevant in determining my suitability for the employment position applied for.
I also authorize any person, school, current employer (except as previously noted), past
employers, and organizations named in this application form and accompanying resume
to provide PSS with relevant information and opinions that may be useful to PSS in
making a hiring decision, and I release such persons and organizations from any legal
liability in making such statements.
Date:__________________ Signature:

Consent to Physical Examination and Review of Medical Records:

I give permission for a complete physical examination by the CNMI Public School
System (PSS), including a drug screening exam and x-rays, and I consent to the release to
PSS of any and all medical information, as may be deemed necessary by PSS in judging
my capability to do the work for which I am applying.
Date:__________________ Signature:

Consent to Drug Testing:

I give permission for the CNMI Public School System (PSS) and its authorized
representatives to collect blood, urine, saliva, or hair samples from me and to conduct any
necessary tests to determine the presence or use of drugs or controlled substances.
Furthermore, I give my consent for the release of the results of such test and related
medical opinion to PSS or its authorized representatives. I understand that if I refuse to
consent, I may be refused employment, or if already employed, subject to disciplinary
action, including discharge from employment.
Date:__________________ Signature:

THIS IS AN APPLICATION—NOT A CONTRACT. I UNDERSTAND THAT

THIS APPLICATION DOES NOT, BY ITSELF, CREATE A CONTRACT OF
EMPLOYMENT. I UNDERSTAND AND AGREE THAT, IF HIRED, MY
EMPLOYMENT IS SUBJECT TO THE TERMS AND CONDITIONS OF THE
EMPLOYMENT CONTRACT FOR CERTIFIED PERSONNEL AND THE
RULES AND REGULATIONS OF THE PUBLIC SCHOOL SYSTEM.
Date:__________________ Signature:

Agreement that C.N.M.I. Law and Courts Govern the Application Process:
I agree that the laws of the Commonwealth of the Northern Mariana Islands shall
govern all aspects of my applying for a job with the PSS and that any legal or equitable
action I may bring regarding my applying for a job and/or any matters related to this
process shall be brought in the Commonwealth of the Northern Mariana Islands Courts of
Law only.

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Date:__________________ Signature:

A MEDICAL EXAMINATION IS REQUIRED FOR THIS

JOB.
IF YOU ARE HIRED, A MEDICAL EXAMINATION WILL BE REQUIRED
BEFORE YOU START WORK. IF THE EXAMINATION DISCLOSES
MEDICAL CONDITIONS THAT PREVENT YOU FROM SUCCESSFULLY
PERFORMING THE ESSENTIAL FUNCTIONS OF THE JOB, PSS WILL
ATTEMPT TO MAKE ACCOMMODATIONS TO ALLOW YOU TO WORK. IF
NO REASONABLE ACCOMMODATIONS CAN BE FOUND, OR THEY CAUSE
AN UNDUE HARDSHIP ON PSS, THE TENTATIVE OFFER OF
EMPLOYMENT WILL BE WITHDRAWN.
Date: Signature:

*************CERTIFICATION OF HUMAN RESOURCES OFFICE***************

Human Resources Office hereby confirms that this application has the required applicant
signatures affixed for:
Representation That Application Is Filled Out Truthfully.
Consent to Investigate Criminal Records/Agreement to Notify PSS of Crime Info.
Consent to Review License/Credential Records & NASDTEC Records.
Consent to Review Employment Records.
Consent to Physical Examination and Review of Medical Records.
Consent to Drug Testing.
This Is An Application—Not A Contract.
Agreement that C.N.M.I. Law and Courts Govern
A Medical Examination Is Required For This Job.

Dated:____________ __________________________
HRO Staff

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 FOR YOUR INFORMATION

Read the rules and regulations for employment:

Many of the questions you may have about employment by the Public School System
will be answered in its employment regulations. These regulations explain the hiring
process in chronological order from recruitment and interviewing, the employment
decision, the employment contract, and the contract period to renewal. Teachers and
librarians will have to be certified in the CNMI for their contracts to be valid. That
process is described in the regulations. The regulations also set the standards of conduct
for employees, discipline of employees and employee grievances. Please take the time to
read them before coming to your interview. They will tell you a lot about our attitude
towards the job for which you are applying. Please refer to www.cnmilaw.org for more
information on the PSS regulations.
What if your interview goes well:
In the event that the PSS Recruiter determines that he or she will recommend you for
employment, then you will be asked to provide a certified copy of your teaching
certificate, if applicable, to the PSS Recruiter along with a local criminal records
clearance. In some cases you may also be asked to arrange to have your post-secondary
institution(s) send an official copy of your transcript of courses, grades, and degrees
awarded to the Human Resources Officer at the CNMI Public School System, P.O. Box
501370, Saipan, MP 96950.
The Recruiter will verify your work experience and contact your present or former
supervisors and co-workers to determine your suitability for employment. The Human
Resources Officer on Saipan shall seek a police clearance if a local CNMI resident
applicant and shall obtain a National Association of State Directors of Teacher Education
and Certification clearance for all applicants.
Your first notice—the Intent to Offer Employment Letter:
If the decision is made to offer you employment, you will be notified by receiving an
Intent to Offer Employment Letter. This letter is not a contract of employment or an offer
of employment; it is notice that PSS intends to make you an offer of employment in the
near future. This offer may not be made despite these intentions for various reasons, such
as budgetary restraints.

When am I employed exactly?

If your application process continues to proceed favorably you will next receive an
executed contract of employment. You are to sign it, keep a copy and return the original.
At this point, you have been hired. However, the contract is conditioned upon a medical
examination that discloses no conditions that will prevent you from performing the
essential functions of the job or that will pose a significant risk of substantial harm to
your health or safety or that of other people in the workplace that cannot be reasonably
accommodated or that will cause an undue hardship on PSS. Before you commence your
contract, you must undergo and submit satisfactory documentation of the results of the
physical examination.

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What about licensing?
Within 14 days of starting your contract, you must submit to the Human Resources
Office a completed application for a teacher, counselor or librarian Basic I certificate.
The results of your physical examination, a statement from a state or national education
agency that you have a license and that it has not been suspended or revoked, two
passport-size color photographs and completed fingerprint cards must be submitted along
with a completed application form. These cards will be provided to the Federal Bureau of
Identification (FBI) to do a more thorough criminal records check to be considered in
determining whether to issue you a certificate as a teacher or librarian. A decision by the
Certification Committee will be rendered within 60 days of the filing of a completed
application along with all necessary documentation. In the interim, the Human Resources
Officer will grant you a temporary certificate so that you may work. The Basic I
certificate will be valid for a period of time equaling the term of your initial contract with
the PSS, unless earlier revoked or suspended. You may also mail your application using
the following format:
ATTN: CNMI State Board of Education Certification & Licensure Office
P.O. Box 501370, Saipan, MP 96950 or,
You may also contact Ms. Jessica Estrada at (670) 237-3027 or by e-mail at
boe.certification@cnmipss.org if you have any questions.

What benefits are given to persons who have to move to accept employment?
Persons with a point of hire that is different than the island assigned for work are
referred to as “off-island hires.” These persons will be provided a contract addendum
entitled “Off-Island Hire Terms and Conditions” to execute at the same time as the
contract. You may ask to see the addendum during your interview. As the benefits
frequently change, the addendum in use during your interview will provide the most
accurate information.
Pending availability of funds, one-way transportation to the CNMI is provided to off-
island hires. Airfare from the point of hire to the island assigned for work and three days
of hotel accommodations and meal allowances are provided for employees and up to
three of their eligible dependants who do not already have a place to stay on island.
Housing allowances are no longer provided to Certified employees. There are a number
of conditions attached to these benefits which are explained in the contract addendum.

How do I find out more about the CNMI?

A commercial Internet service provider maintains a home page for the CNMI on the
World Wide Web at http://www.cnmipss.org. You can also write to the Human
Resources Officer for the Public School System at P.O. Box 501370, Saipan, MP 96950.
You may tear off these last two pages and keep them for your reference. No handwritten
or oral changes to the matters herein are authorized. The information provided is for your
convenience. The Public School System expressly reserves the right to change the
regulations, procedures and contract at any time.

Page 10 of 12
 The following is a list of members from NACES, the National Association of Credential
Evaluation Services. Please contact them directly. Individuals who contact any of these
organizations assume all responsibility for the evaluation services. NACES directory is
subject to change. For more information on NACES members, please refer to their
website at www.naces.org.

Academic Evaluation Services, Inc. Educational Records Evaluation

11700 N 58th Street G & H Service, Inc.
Tampa, FL, 33617 601 University Avenue, Suite 127
Phone: (813) 374-2020 Sacramento, CA 95825
Fax: (813) 374-2023 email: info@aes- Phone: (916) 921-0790
edu.org http://www.aes-edu.org Fax: (916) 921-0793
email: edu@eres.com
Center for Applied Research, http://www.eres.com
Evaluations, & Education, Inc.
P.O. Box 18358 e-ValReports
Anaheim, CA 92817 10924 Mukilteo Speedway, #290
Phone: (714) 237-9272 Mukilteo, WA 98275
Fax: (714) 237-9279 Phone: (425) 349-5199
email: eval_caree@yahoo.com Fax: (425) 349-3420
http://www.iescaree.com email: brad@e-valreports.com
http://www.e-valreports.com

Education International, Inc. Evaluation Service, Inc.

29 Denton Road 333 W. North Avenue, #284
Wellesley, MA 02482 Chicago, IL 60610
Phone: (781) 235-7425 Phone: (847) 477-8569
Fax: (781) 235-6831 email: Fax: (312) 587-3068
edint@gis.net email: info@evaluationservice.net
http://www.educationinternational.org http://www.evaluationservice.net

Educational Credential Foreign Academic Credential

Evaluators, Inc. Service, Inc.
P.O. Box 514070 P.O. Box 400
Milwaukee, WI 53203-3470 Glen Carbon, IL 62034
Phone: (414) 289-3400 Phone: (618) 656-5291
Fax: (414) 289-3411 Fax: (618) 656-5292
email: eval@ece.org http://www.facsusa.com
http://www.ece.org
Educational Perspectives, nfp. Foreign Educational Document
P.O. Box 618056 Service
Chicago, IL 60661-8056 P.O. Box 4091
Phone: (312) 421-9300 Stockton, CA 95204
Fax: (312) 421-9353 Phone: (209) 948-6589
email: info@edperspective.org
http://www.edperspective.org
Page 11 of 12
Foundation for International Education
InternationalServices, Inc. Research Foundation, Inc.
14926 35th Avenue West Suite 210 P.O. Box 3665, Culver City
Lynnwood, Washington 98087
Phone: (425) 248-2255 CA 90231 3665
Fax: (425) 248-2262 Phone: (310) 258 9451
email: info@fis-web.com Fax: (310) 342-7086
http://www.fis-web.com email: information@ierf.org
http://www.ierf.org
Global Credential Evaluators, Inc.
P.O. Box 9203 Josef Silny & Associates, Inc.
College Station, TX 77842-9203 International Education Consultants
Phone: (512) 528-0908 7101 S.W. 102 Avenue
Fax: (512) 528-9293 Miami, FL 33173
email: gce@gceus.com Phone: (305) 273-1616
http://www.gceus.com Fax: (305) 273-1338
Fax: (305) 273-1984 (Translations)
Global Services Associates, Inc. email: info@jsilny.com
2554 Lincoln Boulevard, # 445 http://www.jsilny.com
Marina del Rey, CA 90291
Phone: (310) 828-5709 SpanTran Educational Services,
Fax: (310) 828-5709 Inc.
email: info@globaleval.org 7211 Regency Square Blvd., Suite 205
http://www.globaleval.org Houston, TX 77036-3197
Phone: (713) 266-8805
International Academic Credential Fax: (713) 789-6022
Evaluators, Inc. email: info@spantran-edu.org
P.O. Box 2465 http://www.spantran.com
Denton, Tx 76202-2465
Phone: (940) 383-7498 World Education Services, Inc.
Fax: (940) 382.4874 P.O. Box 5087
email: staff@iacei.net Bowling Green Station
http://www.iacei.net New York, NY 10274-5087
Phone: (212) 966-6311
International Consultants of Fax:(212)739-6100
Delaware, Inc. email:info@wes.org
3600 Market Street, Suite 450 http://www.wes.org
Philadelphia, PA 19104
Phone: (215) 387-6950 Ext.603Fax:
(215) 349-0026email: icd@icdeval.com
http://icdeval.com

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