Please complete this request form and press "Request Application" to send the information online to Fairfield Teachers' Agency.

If you prefer, you may print out the form and FAX the completed form to (203) 334-7224 or mail it to:

Fairfield Teachers' Agency
P.O. Box 1141
Fairfield, CT 06825

First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
Country:
If you are not a U.S. citizen, would you need a school to assist in sponsoring you?
Telephone Number:
Subject Area(s):
B.A. Major
M.A. Major
Are you certified?
If yes, in what State(s)?
Desired Geographic Location:
If relocation is necessary, is your move contingent upon securing employment?
Email Address:

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