Skip to content

Employment Application

MM slash DD slash YYYY

Personal Information:

Have You Been Previously Employed by the Midwest Regional ESC, Shelby County ESC, Hardin County ESC, or Logan County ESC?

When employed, an official transcript of all credits, license(s), and current BCI & FBI background checks must be on file in the office of the Midwest Regional Educational Service Center.

Criminal Records Check: If selected for employment, I acknowledge and agree that, consistent with Ohio Revised Code Section 3319.39, the Educational Service Center will conduct a criminal records check. I understand that the result of this check could legally prevent me from becoming or remaining employed by the Educational Service Center.

What are unemployable offenses? What does unemployable mean? ORC 3319.39 says that no board of education of a school district, no governing board of an educational service center, and no governing authority of a chartered nonpublic school shall employ a person as a person responsible for the care, custody or control of a child if the person has previously been convicted of or pleaded guilty to any of the offenses listed, unless the person has been rehabilitated pursuant to rules adopted by the Ohio Department of Education. For more information about OHIO REVISED CODE 3319.39 and “UNEMPLOYABLE OFFENSES”, please visit http://codes.ohio.gov/orc/3319.39

Licensure: Please indicate below the State of Ohio License/Permit(s) you hold or anticipate receiving. When employed, your license/permit must be on file at the Midwest Regional Educational Service Center before you can be paid.

MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY

If you do not hold an Ohio License / Permit, have you applied for one?
MM slash DD slash YYYY
Are you certified in another state?