Fillable EMPLOYMENT APPLICATION (Northern Maine Community College)

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EMPLOYMENT APPLICATION (Northern Maine Community College)

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File type: PDF

U.S.A. forms for Northern Maine Community College

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Northern Maine
Community College
33 Edgemont Drive
Presque Isle, ME 04769
www.nmcc.edu
EMPLOYMENT APPLICATION
P
lease print all information.
Today’s Date:
MAINE COMMUNITY COLLEGE SYSTEM
PERSONAL
Name:
Last
First
Middle
Other Name(s) Used for Employment
Address:
Phone: Home ( )
City, State, Zip:
Email: Phone: Work ( )
Previous Maine Community College System Employee? Yes No
Position Desired:
If Yes, When? Department:
Availability — Date:
Weekend/Shift Work? Yes No
Type of work you are seeking: Full-Time Part-Time
If Part-Time, days & hours available:
REFERRAL SOURCE
WORK ELIGIBILITY
Advertisement Agency Friend Relative
Do you have the legal right to work in the United States? Yes No
Can you verify your legal right to work in the United States by providing a
birth certificate, proof of citizenship or other authorization?
Yes No
Walk-in Internal Posting Other
EMPLOYMENT
Start with current or most recent employer. Please give complete information for Full-Time, Part-Time and Military Positions, even if resume is attached.
Employed (State Month & Year) Employer Address City, State, Zip
From To
Supervisor: Name, Title and Phone No.
Reason for leaving
Job Titles and Duties:
Employed (State Month & Year)
Employer
Address City, State, Zip
From To
Supervisor: Name, Title and Phone No.
Reason for leaving
Job Titles and Duties:
EDUCATION AND TRAINING
SCHOOL
NAME AND LOCATION OF
SCHOOL
DATES
COURSE OF STUDY
DID YOU
GRADUATE?
DEGREE/
DIPLOMA HELD
FROM
TO
MO/YR
MO/YR
High School
College
Graduate
Tech/Trade
Other
Licenses/Certifications:
Relevant/Specialized Training:
EMPLOYMENT CON’T
Start with current or most recent employer. Please give complete information for Full-Time, Part-Time and Military Positions, even if resume is attached.
Employed (State Month & Year) Employer Address City, State, Zip
From To
Supervisor: Name, Title and Phone No.
Reason for leaving
Job Titles and Duties:
Employed (State Month & Year) Employer Address City, State, Zip
From To
Supervisor: Name, Title and Phone No.
Reason for leaving
Job Titles and Duties:
SKILLS/QUALIFICATIONS
Complete information for job-related skills only
Computers: Type of Equipment
Software: Spreadsheet Word Processing
Statistical Database
Programming languages
Typing: WPM Physical Plant — List Craft Skills:
Other applicable skills:
ADDITIONAL QUESTIONS
Do you have a current ME driver’s license? Yes No
Have you ever resigned from a prior employment or volunteer position after a complaint
has been received against you or your conduct was under investigation or review?
Yes No
Have you ever been dismissed or discharged for misconduct from an employment or
volunteer position?
Yes No
Disclosures to these questions are not necessarily a bar to employment.
Are you 18 years or older? Yes No
If under 16, a work permit must be issued through local
school district.
Have you ever been disciplined by a professional or
licensing board?
Yes No
PROFESSIONAL REFERENCES
Please complete information for three professional references, excluding relatives.
Name
Address
Office Phone
Home Phone
Relationship
APPLICANT STATEMENT
• I certify that the information provided on this application (and accompanying resume, if applicable) is true and complete to the best of my
knowledge
.
• I authorize investigation of all statements contained herein and the contacting of references and previous employers. I release such persons and
all parties from liability for communications involving my potential employment.
• I understand that my application for employment with the Maine Community College System (“MCCS”) may be subject to public disclosure.
• I understand that neither this application nor any offer of employment from the MCCS constitute an employment contract unless a specific
document to that effect is executed in writing by both the MCCS and me.
• I understand that if employed, my employment is for no specified period of time and may be ended by either myself or by the MCCS at any
time.
• If employed, I understand that false or misleading information provided in my application, resume or interview(s) may result in immediate
discharge.
• I agree to abide by all rules and regulations of the MCCS.
________________________________________________________________ _______________________________
Signature Date
Northern Maine Community College is an equal opportunity/affirmative action institution and employer.
For more information, please call (207) 768-2791
Revised 09/2019
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EMPLOYMENT APPLICATION (Northern Maine Community College)

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Completed 26 July 2020

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