Law orrices| WHATLEY & ASSOCIATES 29 PUBLCSUARE 0, BOK a COMMA, TENNESSEE ear 0811, 5. Jason Whatley Telephone: (931) 388-4288 Paralegals Franziska €. Abbott Facsimile: (934) 388-4286 Donna X. Symlar Cory t. Ric wavy. Mitel Montes February 6, 2017 VIA HAND-DELIVERY: Dr. Christopher Marezalc Superintendent, Maury County Schools 501 W. 8" St. Columbia, TN 38401 RE: Mary Catherine Thomas (d.0.b. 05.17.01), 10th grade, Culleoka Unit School Dear Dr. Marczak: I have been retained to represent Anthony Thomas, custodian and father of 10th grade student, Mary Catherine Thomas, regarding extremely serious allegations of inappropriate contact and/or kissing between her and a Culleoka Unit School teacher, Tad Cummins. °Mr ‘Thomas was informed by law enforcement on Tuesday, January 31, 2017 of these allegations. ‘The Maury County Sheriff's Detective who contacted Mr. Thomas was unawate that Mr. ‘Thomas had no idea of the allegations. According to the detective, another student at Culleoka School observed Mr. Cummins kissing my client's daughter on Monday, January 23, 2017 — a fall week prior to his incidental learning of the allegations, Mr, Thomas immediately attempted +0 call the Culleoka School prineipal but was unable to get an answer of any kind, ‘The following day, February 1, 2016, Mr. Thomas contacted your office and spoke with an “Amanda” ~ who my client believes was Human Resources Manager, Amanda Alexander. ‘Ms. Aloxandor expressed concom and regret that Mr. ‘Thomas had been left in the dark about the allegations and further shared her position that the Culleoka School principal was to have done that already. She stated further that the investigation was not complete and that Mr. Thomas ‘would be informed with the findings thereof: Finally, Ms. Alexander insured Mr, Thomas that there would be no contact or communication between the child and the elleged perpetrator, Unfortunately, to date, Mr. Thomas has not heard back from Ms, Alexander —nor has he heard anything further from Maury County Schools on the subject, At the same time, Mr. ‘Thomas’s daughter, Mary Catherine, has informed him that she continues to have at least one class or peiod (“R.T.1.”) with Mr. Cummins, Upon inspection of her cellphone, the two are also having telephone communications.{ ( Dr. Christopher Marezak February 6, 2017 Page 2 of 3 ‘To make matters worse, it appears thet this issue is being readily discussed by faculty members and, on at least one recent occasion, in a derogatory tone and manner about Mr, ‘Thomas? daughter. ‘The purpose of this lotter is to demand as follows: () That we, on behalf of Mr. Thomas, receive an immediate update as to all allegations regarding Mary Catherine Thomas and any inappropriate contact with Tad Cummins, complete with all allegations and facts leamed, statements given by other teachers and students, and any and all other written or recorded information. We are demancling that this information be provided by close of business today; 2) That, also by the end of today, you communicate back to me that measures have been taken to ensure that there will be absolutely no contact or communication between this student and Tad Cummins, @) That we receive a copy of Mr. Cummins personnel files (4) That you coordinate a meeting with me and my client so as to discuss this matter further, the same to be scheduled at your earliest convenience; and (3) That you direct your faculty and staff to cease and desist immediately from discussing these allegations to or within the hearing of other students, | cannct overemphasize to you the concern we have here. While I certainly do not know any facts personally, and while I understand that due process must be observed, I must also express my own outrage that Mr. Thomas has been simply brushed aside by your administration in terms of these very setious allegations. Also, if itis true that contact between this student and Mr. Cummins bas continued in light of these allegations, I can tell you that my client will use ‘whatever legal means are at his disposal, including filing suit, to assist Maury County Schools in protecting Mary Catherine from Mr. Cummins at least until the investigation is complete ~ and my client agrees that it is complete. Your reputation precedes you as a person who is dedicated to promoting and improving our public schools. For that reason, I am sure that you agree with the concems and demands as expressed in this letter. We will assume for now that you also were left unaware that Mr. ‘Thomas had so callously been kept outside the loop regarding his daughter and potential or real threats to her safety. Therefore, we hope that this letter assists in putting us on the same page and we look forward to working with you to that end. look forward to hearing from you today. Tremain,Dr. Christopher Marezak February 6, 2017 Page 2 of 3 Sincerely yours, Fi porn, holy, ‘Attorney at LawStatement from the family of Elizabeth Thomas Mareh 13,2017 We (law enforcement agency releasing the statement) have been asked by the family of Blizabeth Thomas to release the following statement: Family Statement: We want to thank the Maury County Sheriff's Office, Tennessee Bureau of Investigation and other law enforcement agencies working to find Elizabeth, the Amber Alert system for quickly getting out the alert about her, and all of you who have shared her photo and story in hopes of helping to find Elizabeth. Your prayers and support are deeply appreciated. We ask that you continue to share Flizabeth’s story and to immediately notify law enforcement if you think you may have seen her. You can be Elizabeth's eyes, her ears and her voice. Your information or tip may be what leads to getting this child home. Asa family, we are focused on one thing and one thing only ~ Elizabeth's quick and safe return Because of that, we will not be making any further statements, and we ask the news media recognize and respect our desire for privacy as we deal with this situation, Thank you. Family of Blizabeth ThomasScott A. Gaines Assit Spinto ot) Dr. Christopher J. Marczak Superintendent of Schools Beil dtr Maury County Public Schools ‘501 West 8" Street, Columbia, TN 38403 (931) 388-8403, Fax (931) 840-4410 MEMORANDUM Date: 02/08/2017 i From; Amanda Hargrove, Chief 0fStatf RE: Tad Cummins I spoke with Penny Love, Principal Culleoka Unit School, conceming the issues raised in a letter received by my office from Whatley and Associates dated 02/06/2017. ‘The letter states the student still has one class of (RTI) with the teacher. This statement is false, ‘The student’s schedule was changed in order to separate the teacher and student. The student does not have RTI with the teacher. ‘The teacher was suspended from his employment with MCPS on 02/06/2017. ‘The main issues of concern were accusations that the faculty and staff are readily discussing this issue at school and on at least one occasion in a derogatory tone and manner about the student. Ms. Love had no knowledge of derogatory remarks being made by faculty about the student. Ms. Love did receive remarks from faculty concerning conversations between students concerning the incident. Faculty assured Ms. Love efforts had been made to advise students to refrain from discussion of the incident. Ms. Love will meet with faculty during their weekly faculty meeting and address the issue. She will advise all faculty and staff to not discuss the situation whether or not in the presence of students, School administration will do their due diligence to ensure this matter is not discussed by students or faculty. ‘The letter requested the following information which will be provided to Whatley & Associates: 1) Investigation Report from MCPS 2). Personnel File of Tad CumminsInvestigation Report Complaint Managers: ‘Complainant: Date of Complaint: Date of Report: Violation/Allegation: ‘Amanda Hargrove, Chief of Staff and Teneke Claybourne, HR Culleoka Unit Schoo! Administration 01/24/2017 01/30/2017 Inappropriate Conduct by a teacher towards a student ‘A. Nature of the Allegation Student 1 filed a report on January 24, 2017, with school administration accusing a teacher at the school of kissing a student in his classroom, Student 1 named the teacher as Mr. Tad Cummins. Student 1 named the student as Mary Catherine (Beth) Thomas. Undisputed Background Information Tad Cummins has been employed as a teacher at Culleoka Unit School since 2021. ‘Mary Catherine (Beth) Thomas is currently a 9" grade student at Culleoka Unit School. Beth has ‘Mr. Cummins as a teacher for 3" block — Forensics class. . Parties and Persons Involved Tad Cummins, teacher Beth Thomas, student Student 1, middle school student Student 2, middle school student Student 3, high school student Teacher 1, co worker D. Complainant's Position Student 1 states that on January 23, 2017, while walking into Mr. Tad Cummins room to retrieve her bag, she witnessed Mr. Cummins kissing Beth Thomas. In her written statement, Student 1 states “It wasn’t like a make out kiss, ust a peck on the lips.” ‘After witnessing the alleged incident, Student 1 felt uncomfortable and left the room. Upon leaving the room, Student 1 saw Student 3 in the staircase. Student 1 told Student 3 what she witnessed. Student 3 stated during questioning that Student 1 did say she saw Tad and Beth kissing. This was told to Student 3 on the day it happened when she saw Student 1 on the staircase of the school. Student 3 described Student 1 as “freaked out” by the incident.‘The next day, January 24, 2017, Student 1 confronted Mr. Cummins about his relationship with Beth Thomas, Student 2 accompanied Student 1 as she asked Mr, Cummins about his relationship. Mr. Cummins commented to both Student 1 and Student 2 that he isa father figure to Beth. He commented he saw her as a close and best friend. He also revealed to both Student 1 and Student 2 that Beth had been through a lot and had suffered an abusive home life. Student 1 decided to go to the school administration and report what she had witnessed, Respondent's Position Mary Catherine (Beth) Thomas~ admits she does go to Mr. Cummins room when she becomes upset and anxious during the school day. She looks at him like a friend and a counselor who knows how to calm her down when she is experiencing anxiety. She stated students hang out in his classroom a lot. Everyone goes to him if they need to talk to someone. She denies Mr. Cummins has ever kissed her. She denies Mr. Cummins has every acted inappropriately with her or with any other student. She has gone to church with him a few times but mainly hung around: his wife. She stated Mr. Cummins has never made her feel uncomfortable and has never touched her except maybe a fist bump from time to time and he grabbed her hands to calm her down one time, ‘Tad Cummins ~ denies the incident ever took place, Admits Beth isa really good friend and she does leave her other classes to come see him when she needs someone to calm her down. Denies giving Beth a kiss/peck on the cheek or mouth. He states him and his wife have picked Beth up for church a time or two. Mir. Cummins has no idea why another student might make this accusation. He always leaves his door open and is very rarely alone with a student. He loves his wife and has never cheated on his wife and would never do anything to jeopardize his marriage. Issue to be considered 1) Does the evidence support the allegation that Mr. Tad Cummins kissed a student in her classroom as observed by a witness? Evidence for allegations / issues Documentary evidence -written statement, emails, interviews, MCPS Employee Code of. Conduct Analysis ‘A coworker was interviewed during the course of the investigation. Teacher 1 stated that Beth had been seen alot in Mr. Cummins room both alone and with other students during different times during the school day as well as before and after school, Teacher 1 stated the classroom door is always open and has never personally witnessed any inappropriate behavior, Teacher 1also stated that Beth has recently moved her desk by Mr. Cummins desk, Teacher 4 felt as if Beth should not be in Mr. Cummins classroom as much as she is, Teacher 1 also feels as if Mr. ‘Cummins should have a better boundary between his role as the student's teacher and the student's friend. Neither Mr. Cummins nor Beth Thomas confessed to the incident. Neither party admitted to behaving inappropriately towards the other. The student denied ever feeling uncomfortable due to any actions by the teacher. The allegation of teacher Tad Cummins kissing student Beth Thomas could not be confirmed from the evidence presented. Recommendations ‘Mary Catherine (Beth) Thomas will be removed from Mr. Cummins classroom. Administration will separate the student from the teacher. ‘The student will be instructed to bring anxiety issues to the school administration and guidance counselors. ‘Administration will monitor Mr. Cummins classroom to ensure students are not in his classroom when they are not supposed to be. Mr. Curmmins wil be reprimanded in regards to his duty to uphold his professional responsibility and behavior as a teacher to all students. Document List ‘Student 4 written statement Interview notes Email sent from Tad CumminsScott A, Gaines Dr. Christopher J. Marczak ssn cn oe ‘Superintendent ee ee Maury County Public Schools ‘set Spector ‘501 West 8" Street, Columbia, TN 38403, (931) 388-8403 February 6, 2017 Mr. Tad Cummins HAND DELIVERED erect eee Dear Mr. Cummins, ‘This letter is official notification that you ate hereby suspended from your position with Maury County Public Schools pending an investigation. You are suspended without pay until furthor notice, ‘Be aware that this suspension is effective immediately. You should surrender to the Central Office any and all items in your possession that aro the property of Maury County Public Schools, including your MCPS employee baglge. ‘You will be notified as to the disposition of this matter. Any questions concerning this suspension may be directed to Amanda Hargrove, Chief of Staff. Amanda may be teached at (931) 388-8403 ext. 8117. Sincerely, Cc: Personnel file Payroll Department Rougjtou, Amanda Tue, Kenny, ys, L.Brou Educating every child for LIFE!CULLEOKA SCHOOL 1921 WARRIOR WAY CULLEOKA, TENNESSEE S845 a 931-9872511 PENNY LOVE FAX:931-9872594 PRINCIPAL OFFICIAL REPRIMAND SUBJECT: Letter of Reprimand TO: Tad Cummins TITLE: CTETeacher SCHOOL DEPARTMENT: Culleoka Unit School y In accordance with the provision of Maury County Public Schools’ discipline guidelines, { have determined to issue you a formal OFFICIAL REPRIMAND for the following Employee Code of Conduct violati INSUBORDINATION The reason(s) for this actions are as follows: © OnJanvary 31, 2017, you were instructed by Principal Penny Love to not allow Mary Catherine ‘Thomas in your classroom. © OnJanvary 31, 2017, Mary Catherine Thomas was instructed by Principal Penny Love to not be in your classroom, and to seek counseling from CUS High School Guidance Counselor, Alison Reischinan, ifneeded. © On February 3, 2017, Mary Catherine Thomas was in your classroom from 12:11 pan.-12:44 p.m. © This was.a violation ofmmy diréctive to you on January 31, 2017. ‘As provided with the provision of Maury County Public Schools’ discipline guideliries, this letter will be retained in your Official Personnel File, The occurrence of the same or substantially similar Employee Code of Conduct violation during this timeframe may result in more severe disciplinary action. if you question the merits of this action, you may seek rellef in accordance with Maury County Public School policy. if you desire further explanation of these procedures, you may contact the Supervisor of Human Resources, You are requested to acknowledge receipt of this letter on the space provided on the attached copy and return it to the undersigned. Your signature merely shows that you have received the letter and does, not signify that you agree with its content. ‘Signature of Ndministrator hereby acknowledge receipt of this letter on February 3, 2017. Employee Signature Co: Official Personnel FileCULLEOKA SCHOOL 1921 WARRIOR WAY 3 CULLEOKA, TENNESSEE 58451 6 931.987.2511 PENNYLOYE FAX.931-9572504 PRINCIPAL OFFICIAL REPRIMAND SUBJECT: Letter of Reprimand To: Tad Cummins TITLE: CTE Teacher SCHOOL DEPARTMENT: Culleoka Unit Schoo! In accordance with the provision of Mauiry County Public Schools’ discipline guidelines, | have determined to issue you a formal OFFICIAL REPRIMAND for the following Employee Code of Conduct violation: NON PROFESSIONAL CONDUCT (NON-CRIMINAL) The reason(s) for this actions are as follows: Allowing a particular student to spend an excessive amount of time in your classroom creating an unprofessional environment. {As provided with the provision of Maury County Public Schools’ discipline guidelines, this fetter will be retained in your Official Personnel File. The occurrence of the same or substantially similar Employee Code of Conduct violation during this timeframe may result in tnore severe disciplinary action. If you question the mertts of this action, you may seek relief in accordance with Maury County Public School policy. if you desire further explanation of these procedures, you may contact the Supervisor of Human Resources. You are requested to acknowledge receipt ofthis letter on the space provided on the attached copy and return itto the undersigned. Your signature merely shows that you have received the letter and does ify that you agree with its content. thereby ws receipt of this letter on February 3, 2017. imployee Signature Cer Official Personnel Fileote a, Gates | Dr. Christopher J. Marczak Asst Spintec Superintendent 7 Stan J, Breeden | Maury County Public Schools Assit Soperitandant of Operations | ‘504 West & Street, Columbia, TN 38404 (631) 388-6403 ‘January 27, 2017 ‘To Whom it May Concern: We request a change to the historical data for Tad Eric Cummins (license number 0005829. ‘We are unable to determine the level of effectiveness score for 2014-15 due to no Growth ‘Measure seore. ‘We request that the Growth Measure Score of _2 be entered. ‘The teacher is aware of this change as indicated by his signature below. Abia . ‘Scott A. Gaines Tid Corse op amu aveare of tis change to my historical evaluation data. Educating every child for LIFE!ot ( & % Scott A. Gaines a a Aosta De tin, Dr. Christopher J. Marczak a : ‘Stan Breeden ieee ott te Ores Maury County Public Schools Patty Vargo 501 West 8" Street, Columbia, TN 38401. Ascttant Bischof Pnacee (934) 388-8403, Fax (931) 840-4410 Teacher Contract of Employment 2015-2016 ‘MAURY COUNTY BOARD OF EDUCATION by and through its Director of Schools enters into this employment contract ‘with Tad Comming as alan CUE - Health Scianco Teacher at Calleoka Unit School. This contract is agreed upon by the parties, and the annual salary, applioable expplements and Career Ladder payments are determined according to Local and State salary schedales and The Memorandum of Understanding. Salary amounts may be changed due to error or submission of additional teaching experience and/or degree advancement by January 30" of the cutrent school year. ‘understand that Iam obligated to carry oat my dties in accordance with th calendar adopted by the Board unless excused ‘undor the provisions of Board poli or Stato Rules and Regulations. ‘Et any time aay areas of ektea responsiblity are discontinued, that portion ofthe salary will be deducted from the total amount. “The employee understands thatthe responsibilities covered by this contrat, inchuding extra assignments for which supplements ae provided, may not be relinquished in pat by the employee. ‘The employee agrees to observe and follow all Tennossce laws, all niles and regulations of the State Board of Education, and all rules and regulations of the Muury County Boatd of Education. also understand that T am obligated to submit my current and valid teachez’s license to the Director's olfice upon employment or when changes are made, All other employment data and forms mnst be completed in a timely manner. ‘The employee shall not be entitled to payment of any salary for any pay period until reports duo at tat time have boon timely and propealy filed, ‘The Director of Schools resorves tho zight to terminate this contract if necessary in the best interest of the school system becanso of a decrease in enrollment or for other good reasons, ‘Tho employoo agrees fo work in any building os department or perform such duties which may be assigned or required by the Director of Schools, ‘The Director of Schools may temporarily suspend this contract when deemed necessary, pending investigation, In cese of esigaation, the employee agrees to give the Director of Schools thirty (30) days” notice and to continue in service until euch time has trenspireds provided that earlier termination snay be made by mutual written consent of both partis, ‘The employee understands that if filling « temporary/intesim position, there is no expectancy of continued employmeat. A policies and the policy manual of Maury County Board of Baucation ate incorporated by refrence into this contract. ‘The clauses, sentences and parts of this contract are severable to the extent found to be unlawful or ineffective by a coutt of competent jurisdiction and ifso held, the remaining provisions of the contract shall remain in fall foroe and effect. Nothing in this contract shall be construcd to provide future or continued employment unless specifically agreed to by the partios jn a separate agreement. Its undorstood that this contract is subject tothe provisions of all applicable legislative enactments of the General Assembly of ‘the Stato of Tennessee and rales and regulations ofthe State Board of Edneation. es re : ec D2 Cun Mare Gate ———~ yfyf ee ‘Teacher's Signature Date Director of Schools ~ Date TCA49-5-408% & % Scott A, Gaines 3 : aint oer nn Cynthia Johnson § ‘Stan Breeden ntesim Director of Schools Assist car of Opaets Maury County Pubte Schools Patty Vargo 501 West 8" Street, Columbia, TN 38401 sehen ef ae (934) 388-8403, Fax (934) 840-4410 ‘May 15, 2015, ‘Tad Cummins Culleoka Unit School Dear Mr. Cummins: Congratulations! This letter is to serve as official notification that you are renewed as a teacher for the 2015-2016 school year. Thank you. for your continued service to Maury County Public Schools. Respectfully, Congerttnin. Q Gaeanen Cynthia Johnson Interim Director of Schools ciidim, C: Principal Personne! fileia (ara & fe Scott a. Games j Pol tinkey ad Edward A. Hickman a ‘Stan Breeden rector of Schoo ean Eretden Maury County Public Schools . soa west 8! Stret, Columbia, TH 30401 es As (931) 388-8403, Fax (931) 840-4410 May 15, 2014 ‘Tad Cummins on Culleoka Unit School Dear Mr. Cummins: Congratulations! This letter: is to serve as official notification that you are: renewed as a teacher for the 2014-2015 school year. ‘Thank you for your continued service fo the Maury County Public School System. Respectfully, 215.1} % aid Edward A. Hickman 5 Director of Schools BAH/Ajm.itive Educator Licensure Information i Gonerat Fatusafer at Name: CUMMINS, TAD ERIC Liconse Number: 000882939 ‘Search Aasia bo! Exporience (in Yrs): 3 SSN: Conforral Date: Of/07/1983 {og Out Education Level: 2 Yer College Dato Added To Filo: 03/22/2011 Gender: Malo Liconsos & Endorsements ; Num. of Jpescription (Type) [status pate Rocoived expiration Date [Renewal Dato [NUM of Apprentice Inactive: foorrarzort J aararizote ° Joccupational Educ (27) |Superveded oath Sclonce/ Occupations (577) Professional Sree uo cay [Ace vertazare | osratizona lo Health Sclonoa/Occapations (77) Click here for a biof description ofthe 'ypo of leanses, ‘Ban cones status dofinons Pending Review - application has boon received, onlorod into database, given to lleensing spectalist for review. Applilion wil stay In ths stalus unl reviewed and eligbty determined. Requirements not met - apaleation has been reviowed and dofciencies determined. You will racelve ‘correspondence fom licensing specialist defining the daficioncy. ‘Active status application roviowod with no deficiencies, oanso was issued. Education Education tennegsee College State College Dato Degree Date Added to Level a Located Conferred File 2Year Columbia Stato Community py pees edges Collage (20) College “This fects all education reported to tho Office of Teacher Licensing. Carver Ladder Doscription No records found, ‘Tosts Submitted tothe Office of Teachor Liconsing Deseription ‘Seore ‘Test Data | No tests found, : | \Wetslte only reflocts tests reported to the Stats Department of Education, ‘Tests That May Ba Usod For Demonstrating Highly Qualified Status Doseription Score Date Acquivod [No toate found! that can be used for Highly Quali. Highly Qualifed Test Searoh: Tests lstod horo aro only those found Inthe Department of Eitucationtcensing database, Highly Qualified Status‘Subject Grado Spat ** [No racords found, “This lnformation reflects Highly Quafffed status as reported to the stats by oval schoo! systems, Educator Experience: bate Bose Syaam Dalo Ended ont Teaching ‘Number Assignment Teaching Days ae potorat Nau County ener (Te) o12.08-0 10-00 TW sovaror —‘MauyConly woTeitT) aorsaog0 090-00 TN aoreoray — Muuyeany Seen) argosan 010-09 TN fers Tot YeneNonbsbaye 200 Fos “This information reflect all exporianca reported tothe State by local school systems through the ast school ‘year. The current academic year fs not inciuded. Correspondence Received Dato Received Documont Type 91212011 Occupational Advancement ariar2014 ——Cecupational Application Disclaimer This information le based upon documentation recslved bythe Office of Teacher Liconsing. 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(peetanguge ety) RENROCEMENT TOPRCFESSIONAL LEVEL ADINISTRATOR INS RENEWAL OF OR AMENDMENT TO AN EXISTING LICENSE ‘OMLY APPLICABLE EMINENT TEINESSES IGEN RENEWAL OP LICENSE (Oman) ENE ar timen frenetic Stl roysOutotS) __JROTG __10Yoer Lieto oestrus pa un) Roster ele iegrrocstore) "8 Yur apace Omyncdisiee "fo vexr Momatnaomnanoes tntee —— ‘Rtn A Spee iat) Est —— In Deeb Nara or Caeaon [MEMENTO Ao ADDL GEST Yo teAtiNGLICENGE (SHA Gn he SUR a ae el era) intr dope esas Dee «Sdeansterrns tne" taraten pellet edo Bagot ‘Ruslan 10 0d ENDORSEMENT Aca 6) 10 TEACHING LICENSE ey aa ed) ME CHANGE fetes armen ny eth mao lor, cords, nt eet aed ia ga ae Tage Bn Soy cada _ADDIRESS GURNEE NOTION rast [MUGT CORPLETE AND SUDIT BOTH PAGES OF APPLICATION sevens I ‘ | |FEMMESSEE STATE UNIVERSITY sb oe, ee nt le Pe on Eef rEAINIES SSEE mS aos : a ; BP I S| OB AG pat {5fos fENNESSEE CC TATE UNIVERSITY GAS Sa ee a 22a Se ES SF ORS9 GAM) bRECEIvep JUL 284 2014 Offies oF Division OF instructionoo HUMAN RESOURCES( Mailed 44-( TENNESSEE DEPARTMENT OF EDUCATION - OFFICE OF TEACHER LICENSING 710 JAMES ROBERTSON PARKWAY ATH FLOOR ANDREW JOHNSON TOWER NASHVILLE TN 37243, PRINT CLEARLY - Please provide full name - include any ellases: Ae cyoal aol errmmcll aS i Mahe Ae INFORMATION NEEDED FOR FEDERAL REPORTING - COMPLETE BOTH ETHNICITY & RACE 1. Ethnicity - Chooss one Hispanic or Latino, Not Hispanic or Latino, 2, Raco Choose one or more _—_-Amarican indian or Alaska Native ___ Asian ___ Black 0, Aiican American. Native Hawatian - Other Pacific Islander Whi PLEASE READ CAREFULLY BEFORE SIGNING - MUST BE COMPLETED persinatAimation: Fat o complet hs sctan wl eeu a your aplication being tuned without processing, Face staments mad In thle application mey conntite grounds tote elon, ovaks or deny’ lownen. Cheah the apprapine lock french question. DO HOT lncuc mates tha tho Stso Boer of dvcaton bas aoa Investigetad and found Wo Probable Cause" to lake any dleblinary sin. I neyeuten contr tio ain concen an anent ay arenctrdocaedsrcrocersanng reid =) glo? 1s» wo 2. nou bun consi te ge foesten oos, itag canine aint apotnacarendett | ~ ran ir grag pro hers? vs 10 "isu jeunada eachrs threes oo super rhe cuvette mcreeome {oli @teaeo were doo ot pp? Te 0 [ts thre any aofon pcg sesh! your eatictatisare or appeaton in sone ss? Ty 7200 you fave anewored "oe" to queens for, leat asc deals of conto, iohing dale and pace of conven, nd court carted copes ef tho judgent conven, and sentencing, orp ekeumstrce liryeu have answarad "ye to yialians 94 attah deta naseg typ etal andor fsung story [signature Date_ ZZ — LL TRANSACTION (S) REQUESTED. (Check and complete following page(s) ifappliceblo} ‘CHOOSE TYPE OF INITIAL TENNESSEE LICENSE DESIRED (THIS SECTION ONLY APPLIES TO THOSE WHO HAVE NEVER HELD A TENNESSE LICENSE OR DESIRING ADDITIONAL LICENSE TYPE) IHITAD LIGENSE-TN nto Only (Apprentice, Appa Speci rou, Sepening Arse, or inion Lea) sie oa, DOUTOF STATE ICENGE Cregem cpl ufo of TH/ USA or pafing hes upon rite seer) NoWPURLC SCHOOL LIGENEE (Employment veteaton equ) {TRANSITIONAL HEHE (Requise spear fom TN Dect af Sebel and ataten fom pproved nsslnagsne) [INTERIM LICENSE (Rane tae For Cie Soa. a yeni om a Dosen Os ches pepaata hso) INTERIM? LICENSE (Roques nat of Dean of Educaton at mcherpeptaion hstuon) ‘OOGUPATIONAL EDUCATION LICENSE (Appence Ooxupatzrl) PPERIMIF (Tip net Temseso tnching Hoones sean ely be apple fer bya Teanessoo Puble Seat Sten) SYEAR INTERNATIONAL OREDENTIA (Ronee sgnatire frm Deer of Sahl, avenewsble) JROTC LICENSE (Regus nate fom TN Draco of Sch) SPEEGHLANGUAGE PATHOLOGIST OR SPEECH ANGUAGE TEACHER OR 80HOOL AUDIOLOGIST NATIONAL BOARD CERTSICATION HEATLEY "ADVANCEMENT TO APPRENTICE LEVEL OR PROFESSIONAL LEVEL LICENSE, (ONLY APPLICABLE IF HELD A ‘PREDECESSOR TENNESSEE LICENSE) ADVANCEMENT FKOM APPRENTICE. LEVELTO PROFESSIONAL LEVEL (Profstnd or Pofesonal tol Sevice Peron) lv on [ADVANCEMENT PROM INTERIM" B'"70 APPRENTICE LEVEL (Apeentca er Out of Sit) ck one, ‘AEVANCEMENT FROM INTERIM "D"TO APPRENTICE EVEL ‘ADVANCEMENT FROM ALTERNATIVE" I" OR ALTERHATIV Il (Appel or Ou of Bi or Proce) ts ona [ADVANCEMENT FROM TRANSIIONAL (apprentice or Prefesson) che one ‘ADNANCEVENT FROM APPRENTICE OOOUPATIONAL TO PROFESSIONAL OCCUPATIONAL LICENSE CONVERSION FAOM TENNESSEE TEAGHING LICENSE TO SCHOOL SERVICH PERSONNELLICENSE (SpoochLenquape cay) “ADVANCEMENT TO PROFESSIONAL LEVE!. ADMINISTRATOR LICENSE ITLL ‘AINANCEMENT FROM ALTERNATIVE" A" of ALTERNATIVE COR ALTERNATIVE*E” TO APPRENTICE LEVEL ope or Out Sitka ca, RENEWAL OF OR AMENDMENT 10 AN EXISTING LICENSE (ONLY APPLICABLE IF AMENDING AN EXISTING TENNESSEE LICENSE) RENEWALOF UCENSE (Chazkens) EM Yoo zene Ponts hoprntcs Spal GoupOutot Sai) __46Yoor tense (PrefsionalPrcensns Special ep) rte Use epengminin.—8Yea Apps xp are 10Yab Probst Cpa Honea ee Morais A (Sch Lanpeny) nnn D___Trenairat opal Boar Ceaton |___AtlewowenFOAbD ADDTTONAL DEGREE TO TEACHING LICENSE! (Gieck oe cfs Tooniny a aac iil src) ast’ Dogs —— Edueton Spottt atts Days +0 caret Docioate Dap “FaieNOWEIET TO ADD ENDORBENENT AREA (6) TO TEACHING LICENGE Qsertiy rea obaategy AME CHANGE ome eed ew ane een, ace en ot ate lin aed el a ced ai eer ‘ADDRESS CHANGE NOTIFICATION [DUPLICATE CPNSE owns Tomes ne er Cops nnd pecan be ros) page revexont HAI9319977594 ‘CULLEDKA UNIT ScHODL, PAGE 02/83 Maury County Public Schools Employee Information Completion Verification For New-Hires/Re-Hires Licensed and Classified Personnel Ted Commins twa completed initial paperwork and js now released to report to 1 Cutleoka ___to begin employment as a. teacher : Employee is seeking the following tecahing crederital: ok (@ z OS 20U “Hun Resources Oficial Gonigletion Dato of Oxi ‘This portion is to be completed by the Psincipal/Department Head and returned to the Bnawan Resources Dapt, ‘The date fo be filed in should he the first day the employec actually reported to work. This date isto be _usod for payroll purposes. Payroll will begin on the date listed below. i - & Sed Oy ream, _____teported to work on, paeeeeeeeee Employes Name ie (day on the wo Ad. chede SManQ a Calbek Position 01 / Location. apreke a eee ee Ag Jf Head Signatare ‘Today's Date co: payrontfo o., Mailed 4-4-1] ‘TENNESSEE DEPARTMENT OF EDUCATION - OFFICE OF TEACHER LICENSING 740 JAMES ROBERTSON PARKWAY 4TH FLOOR ANDREW JOHNSON TOWER NASHVILLE TN 97243 include any aliases moe fo o Tp ar ig TT 5 INFORMATION NEEDED FOR FEDERAL REPORTING - COMPLETE BOTH ETHNICITY & RACE : 1, Ethnicity - Choose one Hispanic or Latino Not Hispenic of Latino 2, Race - Choose one or more “American Indian or Alaska Native Asian ___ Black ox African American Native Hawaiian - Other Pacific Islander. White PLEASE READ CAREFULLY BEFORE SIGNING - MUST BE COMPLETED Personal Attemston: Pate o comple ths sxcton wil result In yor ppleation boing roared without procoseing. Flee ettements made inthis Inepeation may consti ground fo ake aton,rvke or seny a lense. Chas theappropent bck foreach question, DO NOT side mates hat the [stale Board ct Education has already ivenigaled’ end found "No Probable Cas” fo ako any deeipoayaeion, Have oubeen sonic fatty, acdracontsenon aati, ale cra setn an crb ging tl =|” pion? ees So f. Have ja boon contd tho og posession orgs, chung conn on pls of wl ls ofr contd re ot ofan ier grag otal Grr? : mares Ln [3 Have youd teachers cations oko, suspended or dni, have you votre ea (afoung'azcas wo ee os reap? ves 4.1 thar any actenponsng agi your erations or apical encore? xe Zw i you havo answers "ex" to quetione tor, ploasa aac deta of conto, Ioldng data and place of eonvoan, and court ceed cope ofthe udament, conven, and entering. you have answered "es" fo yen 9 or tic dete nang tp sta andor leeving aushory ant win crumatanos, [signature Date JZ — ZL. TRANSACTION (S) REQUESTED. (Check and complete following pago(s) if applicable) ‘CHOOSE TYPE OF INITIAL TENNESSEE LICENSE DESIRED (8s SecTIO ONLY APPLIES TO THOSE WHO HAVE NEVER HELD A TENNESSEE LICENSE OR DESIRING ADDITIONAL. LICENSE TYP) one STAT LCENSESH wstulne Ony pete, po Spel Gey, Roisin hime!) icine = Guror erate uvetics (eu soleus vse FTN USAer oping sees pen ars aera TI __Roweponue Scvco. iceNse fegorrrt resin eed) = Telvemowan lost (tee cpt or Orosrat cena rin fon gpa etalon) = TER Lense aren age oes m tncaeo Ctiner aeeme ste INTEN-o- OBIE nents Sar Grant 2aton tester peprston ) TZ OCCUPATIONAL EDUCATION LICENSE Appenice Occpaona) PERI stares uring ses encom ony bape ory x een Pie Set Se) 5 Year ATERIATONAL CREEL emp emt Sesor eecs,enn) “nove LDEIseentes eartan oo Droste) Seencivuwtousor Parioioosr on OrseoHANOUADE TEACHER On ScHCL AUDIOLOGST NamionnL DOA cBrieATON "ADVANGEMENT TO APPRENTICE LEVEL OR PROFESSIONAL LEVEL LICENSE (ONLY APPLICABLE IF HELU'A PREDECESSOR TENNESSEE LICENSE) ADVANCEMENT FROM APPRENTICE LEVEL TO PROFESSIONAL LEVEL (Prfssoa er rfstional School Sense Peron) icin ns, ‘ADVANCEMENT FROM ALTERNATIVE" A ALTERNATIVEC® OR ALTERNATIVE" TO APPRENTICE LEVEL Uepentce or Ou o Sta)dade ona = Aavaticetenr os iieRid "70 APPRENTICE LEVEL (Aprontn or Out Stas) sila one Tl __ovancenenrrRow WE “010 APPRENTICE LEVEL, 2 ROVANCEMENTFROM ALTERNATIVE *1* OR ALTERNATIVE U*(Agpance Out Sit or Prbesons) islam, = RovANGENENT FROM TRANSTIONAL (Appentce ee Pression) eon = _ovanoestenir Row APPRENTICE OCCUPATIONAL TO PROFESSIONAL OCCUPATIONAL LICENSE ‘CONVERSION FROM TENNESSEE TEACHING LICENSE TO SCHOOL SERVICE PERSONNEL LICENSE. (Gpeechtarguegscnly) ‘ADVANCEMENT TO PROFESSIONAL LEVEL ADMINISTRATOR LICENSE RENEWAL OF OR AMENDMENT TO AN EXISTING LICENSE (ONLY APPLICABLE IF AMENDING AN EXISTING TENNESSEE LICENSE) RENEWAL OF LoENSE (Checkon) ep ear Licenea Apron gprntio Spotl GeupiOker Sis) __ 10 Year Leen Prfsslonalcteesoal Spt Grp) hese ee eprenyProssera,——SYetr epee saya nose Yer Pree pan Loe MEUM Alsoatve A(Specch Langer) rove B__otipD_—__Trsasenal Nara Board Caeaton ___-AMBVoMENT'TOADD ADDITIONAL DESREE TO TEACHING LICENSE (heck neo he avin aed ah sl anni) Mase? Dose avon Spee Masters Dg 90 ssi hours Decale Depes “FSiENEMENT TO ADD ENDORSEMENT AREA.) TO TEAGHING LCEHSE (ently sean be mde NAME CHANGE pees ue coy tearing ae rs, cost el rad naa arg BES Sead Hs ‘ADDRESS CHANGE NOTIFICATION DUPLIGATE LICENSE Gute al Terres ere enters ct pseab beet) page revezersPLEASE POST MAURY COUNTY PUBLIC SCHOOLS 501 West Kighth Street ‘Edward A. Hickman, Director of Schools Columbia, Tennéssee 38401 (931) 388-8403, extension 0119 wwwemamyk12.org Jobline (931) 388-8403, prompt 2 DATE OF POSTING: REPOSTED JULY 8, 2011 POSITION: “Health Science Teacher “Pending Funding for 2011-2012 SY. DESCRIPTION/QUALIFICATIONS: The ‘Teacher shall be responsible for teaching Health Science Instruction, and all assignments as made by the Principal which shall include, but is not limited to coaching, and/or extra co-curricular duties and any other duty as assigned by the Principal. Must have RN Certification and 3 years experience in last five (5) years, and any other appropriate endorsement, certification, training and experience. ’ JOB LOCATION: Culleoka Unit School APPLICATION DEADLINE: Indefinite SUBMIT APPLICATION TO: Human Resources Department 501 West 8* Street Columbia, TN 38401 ‘ALL APPLICANTS MUST REQUEST AND COMPLETE AN EMPLOYMENT APPLICATION FROM THE HUMAN RESOURCES: DEPARTMENT OR WWW .MAURYEI2.0R6, AS PART OF THE APPLICATION PROCESS. CCorront federal Jaw requizoa identification and eligibility verification pefor to employment. One or more of the following documents must be ‘provided porto issuance of an employment cnntract: EMPLOYMENT AUTHORIZATION IDENTIFICATION ‘Social Security Card ‘Stans Drivers Livense Certiate of US. Birth USS. Passport or other approved USS. Passport or other approvedt UWS. Government documents USS, Government documents ‘NOTE: IF THERE ARE ANY ACCOMMODATIONS YOU MAY NEED IN ORDER TO INTRRVIEW AND/OR MAKE APPLICATION FOR ‘THIS POSITION, PLEASE CONTACT JERRY D. WILSON, HUMAN RESOURCES SUPERVISOR, AT 388-8403, BX 0119. AN RQUAL OPPORTUNITY EMPLOYER ‘The Manny County Board of Beaton doesnot cscriinate onthe asec, creed allen, natlosalerlgi,age, gonder, mart satus, sailor ery othr “unl area tn the cpencton oft cational prograns an pesorl adnanCULLEOKA UNIT SoHNCL PAGE 63/85 07/25/2011 saige7gee4 Ka MAURY COUNTY PUBLIC SCHOQf iY a RECOMMENDATION FOR EMPLOYME! (ame) 28 2 full-time part-time. Health Sclonces Teacher Position) Caltostea Bective Z2s/t ‘(Bohoo! or Site) (Bate) ‘The following applicants were interviewed for the position (included recommended applicant): APPLICANT'S NAME: RACE / SEX: DATE OF INTERVIEW: Ted Cumming wa. TPS ‘GF additional lines are needed, use the beck of this form) {certify that Ihave reviewed my reéommended applicant's employment application and supporting documentation including refiyences that are filed in the Human Resources Department, Maury County Bi ‘Education, Sool aay Dap HE Ta Ltl- 71 3 _~Ilb -933 e Aa sf Soe Budget Account # (Cate A Sy, DONT WIEBE Te aaa LS. HUMAN RESOURCES DEPT. USE ONLY Ga brome f Ae, e ‘The recommended applicant: (check all 5 te items) ——hss completed application on file; _/ has TN teacher Licenses ___has the appropriate endorsements; Will require a waiver for, 5 ___will require a permit; ___Will require a transitional Hcense ——#pplicant is Highly Qualified in the are of. en t7019 \.Spniya, PeoleyCumonle, Olarge prsperty Uy .Qlelen ,S26—