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Application This is an Adobe Acrobat fill-in form. (Piedmont Virginia Community College)

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The Application This is an Adobe Acrobat fill-in form. (Piedmont Virginia Community College) form is 3 pages long and contains:

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  • 6 check-boxes
  • 35 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Piedmont Virginia Community College

BROWSE PIEDMONT VIRGINIA COMMUNITY COLLEGE FORMS

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Desk Staff
Application
This is an Adobe Acrobat fill-in form. Fill-in forms allow you to enter information while the document is
displayed by Adobe Acrobat or Adobe Reader and then print the completed form. Please submit
application to Todd Parks, 617C Main Building. Applications will be accepted until all positions are filled.
Contact Information
Last Name _________________ First Name ________________ Middle Name _____________
Preferred Name _________________________ Student ID Number (emplid) __________________
Street Address _______________________________________________________________________
City ___________________________________ State _____________ Zip Code ___________
Telephone Number ________________________ Alternate Telephone Number _______________
Email Address ________________________________________________________________________
Qualifications (the following qualities are not required, but they might make you more competitive)
Do you qualify for federal work study? Yes ☐ No ☐
Have you completed ITE 119 Information Literacy? Yes ☐ No ☐
If you yes, did you earn a B or higher in ITE 119 Information Literacy? Yes ☐ No ☐
Questions (answer all questions to the best of your ability)
Please describe your experience interacting with people in professional settings (e.g., retail job, on-
campus employment, restaurant work, volunteer experiences).
Desk Staff
Desk staff may be asked to use computer software (e.g., Excel, Internet Explorer, Word) to create
documents and reports. Please describe your computer skills.
What experiences have you had with diverse populations?
Please tell us why we should consider your application for employment.
Desk Staff
Related Experiences
Please list recent activities such as part-time jobs, participation in campus organizations, or volunteer
efforts. You may attach a resume if you desire.
Employer/Organization
Title/Functional Area
Date
Location
References
Provide the name, phone number, and email address for two references.
Email
Telephone Number
I hereby authorize and give permission to representatives of Piedmont Virginia Community College to
make any and all appropriate inquiries regarding my background, references, employment records, and
other matters related to my suitability for employment. This may include a background check of my
criminal history data and a check of my driving record. I also authorize my former employers or any third
party to disclose to Piedmont Virginia Community College all reports and other information related to
my suitability for employment, personal or otherwise, without giving me prior notice of such disclosure.
I hereby release Piedmont Virginia Community College, former employers, and all references listed
above from any and all claims, demands, or liabilities arising out of or related to such investigation or
disclosure.
Signature ___________________________________________ Date ________________________
Submit completed application to:
Todd Parks, Coordinator of Academic Support Services
Piedmont Virginia Community College, 617C Main Building
Thank you for your interest!
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Application This is an Adobe Acrobat fill-in form. (Piedmont Virginia Community College)

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Completed 4 February 2021

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