Required Fields Marked With "
*
"
Note: For data collection purposes, please use proper punctuation (i.e. capitalization).
First Name:
*
Last Name:
*
CUSD Employee Number:
Please enter your five digit Employee ID #. (If you do not know your employee ID # please contact your office manager.)
*
Street Address:
*
City:
*
State:
*
Zip:
*
Phone (School):
*
Phone (Home):
*
Phone (Cell):
*
CUSD Email Address:
*
CUSD Employment Status:
Select One
Temporary
Probationary
Tenured
Substitute Teacher
Student Teacher
Cert. Hourly - Adult Ed.
Non-CUSD Employee
*
Current Position:
*
Current Assignment (School):
Select One
Adult Transition
Aliso Viejo MS
Ambuehl
ANHS
Arroyo Vista ES
Arroyo Vista MS
Barcelona Hills
Bathgate
Benedict
Bergeson
Bernice Ayer MS
Bridges
Canyon Vista Elem
Carl Hankey ES
Carl Hankey MS
Castille
Chaparral
Concordia
Crown Valley
CVHS
Del Obispo
DHHS
Districtwide
Don Juan Avila ES
Don Juan Avila MS
Fred Newhart MS
Fresh Start
George White
Hidden Hills
Junipero Serra High
Kinoshita
Ladera Ranch ES
Ladera Ranch MS
Laguna Niguel ES
Las Flores ES
Las Flores MS
Las Palmas
Lobo
Malcolm
Marblehead
Marco Forster MS
Moulton
Niguel Hills MS
Oak Grove
Oso Grande
Other
Palisades
R.H. Dana
R.H. Dana ENF
Reilly
San Juan ES
SCHS
Shorecliffs MS
SJHHS
Student Teacher
Substitute
THS
Tijeras Creek
Viejo
Vista Del Mar ES
Vista Del Mar MS
Wagon Wheel
Wood Canyon
Current Program Assignment (SDC, SDC/Autism, APE, etc...):
*
Please indicate other preferences below by listing 1,2,3, etc... according to your priorities. Select 0 for any that you will not consider.
LEVEL
Preschool:
Select One
0
1
2
3
4
5
6
*
K-2:
Select One
0
1
2
3
4
5
6
*
3-5:
Select One
0
1
2
3
4
5
6
*
6-8:
Select One
0
1
2
3
4
5
6
*
9-12:
Select One
0
1
2
3
4
5
6
*
Adult:
Select One
0
1
2
3
4
5
6
*
PROGRAM
DANA ENF:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/NS:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/SH:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/Autism:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/ED:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/DHH:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
APE:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
Speech Path:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
Other:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
Specify (other):
*
I have read and agreed to the "Summer School Guidelines for Employment".
*
I am available for the entire Summer School session.
Elementary & Middle: June 22 through July 23
High School: June 22 through July 30.
*
Signature:
*