[City of Sacramento] Instructor Application Form

Instructor Application Form

Applicant Information

Phone Number

Class Information

Proposed Class

Have you taught this class before?

Yes

Location

Date you taught the course

May we contact that location as a reference?

Yes

Contact Number

Education

High School

From

Did you graduate?

Yes

College

From

Degree

Did you graduate?

Yes

Other

From

Degree

Did you graduate?

Yes

References

Full Name

Company

Phone

Relationship

Address

Full Name

Company

Phone

Relationship

Address

Related Employment

Company

Phone Number

Address

Job Title

Supervisor

Responsibilities

From

Reason for leaving

May we contact your previous supervisor as a reference?

Yes

Company

Phone Number

Address

Job Title

Supervisor

Responsibilities

From

Reason for leaving

May we contact your previous supervisor as a reference?

Yes

Convictions: Conviction of a crime is not necessarily a bar to provide contract services to the City of Sacramento. Each case is considered separately based on the services provided. Some services may require a FINGERPRINTING check as verification. You may omit: a) Traffic violations (driving under the influence convictions must be reported); b) Any conviction committed prior to your 18th birthday which was finally adjudicated in Juvenile Court of under a youth offender law; c) Any incident sealed under Welfare and institutions Code Section 781 or Penal Code Section 1203.45; d) Any marijuana conviction more than two (2) years old, described in labor code section 432.8

Have you ever been convicted of a misdemeanor?

Yes

Please state WHAT conviction, WHEN, WHERE, and DISPOSITION OF CASE.

Have you ever been convicted of a felony?

Yes

Please state WHAT conviction, WHEN, WHERE, and DISPOSITION OF CASE.

Please upload any additional information about yourself that would further explain your desire to be a contract instructor.

Click Here to Upload

Disclaimer & Signature

First Name

Last Name

Choose how to sign

Draw Type

Contract instructors are contracted with the City of Sacramento to provide instruction for specialty recreation activities, and are therefore not employees of the City of Sacramento. Contract instructors shall be dismissed at any time if the Department finds their instruction to be inadequate, or their behavior, attitude, or appearance to be unacceptable. Please attach any additional information about yourself that would further explain your desire to be a contract instructor. I certify that all statements in this application are true and complete. I agree and understand that any incorrect statements or omissions of material facts herein will cause forfeiture on my part of all rights to contracting with the City of Sacramento. I authorize the City of Sacramento to investigate any and all information regarding employment, scholastic records, together with all other job related information that may or may not be on record. I release all individuals who provide information to the City of Sacramento from all liability regarding the use of such information.