Maine Academy of Natural Sciences
PO Box 159, Hinckley Maine 04944

DISCLAIMER: Maine Academy of Natural Sciences (MeANS) does not discriminate in the operation of its educational and employment policies and will honor all appropriate laws relative to discrimination.

Education: Copy of transcript, including grades, from all college(s)/university(s) attended must be provided.

Please put the number of credit hours beyond your last degree:

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Certification/Licensure: List certification(s)/license(s) you hold and provide copies.

If you do not hold a Maine certificate/license, for what type of Maine certificate/license are you applying and eligible?

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NOTE: Candidates who do not hold Maine certification should direct an inquiry to the Maine Department of Education, Division of Certification and Placement, Augusta, Maine 04333, (207) 624-6603 or 624-6854.

Employment History/Experience: For the last ten years. Please account for any gaps in employment and provide via upload. A resume must be provided.
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Have you ever been disciplined, discharged, or asked to resign from a prior position?
Have you ever resigned from a prior position after a complaint had been received against you or your conduct was under investigation or review?
Has your contract in a prior position ever been non-renewed?
Have you ever not been nominated for re-employment in a prior position or ever had your nomination for re-employment not be approved?
Have you ever been charged with or investigated for sexual abuse or harassment of another person?
Have you ever been convicted of a crime (other than a minor traffic offense)?
Have you ever entered a plea of guilty or “no contest” (nolo contendere) to any crime (other than a minor traffic offense)?
Have you ever had a professional license or certificate suspended or revoked in any state, or have you ever voluntarily surrendered, temporarily or permanently, a professional license or certificate in any state?
Has any court ever deferred, filed or dismissed proceedings without a finding of guilty and required that you pay a fine, penalty or court costs and/or imposed a requirement as to your behavior or conduct for a period of time in connection with any crime (other than a minor traffic offense)?

If you have answered YES to any of the previous questions, please upload document explaining full details, with respect to court actions, the date, offense in question, and the address of the court involved. Conviction or other disposition of a crime is not necessarily an automatic bar to employment.

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References: Please list below and provide three letters of reference (two of whom are most recent supervisors) from persons who are not related to you who can comment on your ability. This application will not be considered complete until references are received.
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My signature below constitutes authorization to check my employment history, including without limitation, criminal arrest and conviction record checks, reference checks, and release of investigatory information possessed by any state, local or federal agency. I further authorize those persons, agencies or entities contacted in connection with my employment application to fully provide Maine Academy of Natural Sciences any information on the matters set forth above. I expressly waive in connection with any request for or provision of such information, any claims, including without limitation, defamation, emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against Maine Academy of Natural Sciences, its agents and officials or against any provider of such information.

I understand that information submitted in and with this application may be disclosed to a screening and/or interviewing committee, which may include board members, administrators, other staff, and members of the community. I give my consent to this disclosure.

Your Signature

NOTE: All application materials become the property of Maine Academy of Natural Sciences (MeANS). None will be returned. Applications will be retained for a period of 12 months from the date of receipt. Providing any false or misleading information on this application or in the application or employment screening process shall be fully sufficient grounds to refuse to employ the applicant or, if the applicant has been employed, to immediately dismiss the applicant/employee.


Tel: 207-238-4000

Fax: 207-238-4007

Email: info@gwh.org

16 Prescott Drive

PO Box 159

Hinckley, ME 04944

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