Fillable Edccapplication 000 (Edmonds Community College)

Fill Online, Printable, Fillable, Blank Edccapplication 000 (Edmonds Community College) Form

Use Fill to complete blank online EDMONDS COMMUNITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Edccapplication 000 (Edmonds Community College)

On average this form takes 62 minutes to complete

The Edccapplication 000 (Edmonds Community College) form is 5 pages long and contains:

  • 1 signature
  • 50 check-boxes
  • 219 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Edmonds Community College

BROWSE EDMONDS COMMUNITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
HUMAN RESOURCES OFFICE
20000 68
th
Avenue West, Lynnw
(425) 640-1400 www.edcc.edu
ood, WA 98036
Instructions: This application must be filled out completely and signed to be considered.
Position Title ________________________________________________________________________________________________________
Date ____________________________________________________
Social Security Number (required by RCW 41.48)
ERSONAL DATA
First Middle Initial Mr./Ms./Dr.
P
Last
Name
Mailing City State ZIP
Address
Home
Telephone
Business
Cell Phone / Email
Telephone
List other names under which you have been emp ded school or are otherwise known other than described above. loyed, atten
Have you ever worked at any other Washington State agency or institution of higher education? Yes No
If yes, give agency or institution name and dates.
Have you ever been, or are you now, a member of a Washington State retirement plan? Yes No
If yes, which one? (TRS I, TRS II, PERS I, PERS II, PERS III, TIAA-CREF, etc.)
Have you been convicted of a felony within the last seven years which may relate to your fitness to perform the particular job for which you are
applying? (A conviction record is not an automatic bar from employment. The nature of the offense and evidence of rehabilitation will be
considered.) If yes, please explain. Yes No
Can you provide proof of United States citizenship or authorization to work in the United States? Yes No
If not a U.S. citizen, what type of work visa?
The following applies to applicants for classified staff positions only:
Are you a veteran of the U.S. Armed Forces?
Yes No
benefits? Are you receiving veteran’s retirement or disability
Yes No
Do you wish to claim veterans’ preference?
Yes No
(If yes, a copy of DD214 must be attached. Veter active dutans preference must be claimed within eight years of the date of release from y.)
Are you willing to work in a corrections facility? Yes No
How did you first learn about this position opening? (check only one)
EdCC employee Friend Posted announcement (where): ___________________________
Search engine (Google, EdCC w Periodical (which one): ___________________________ etc.) eb page
Newspaper (which one): ____ Other (please be specific): ___________________________________________________ _____
Ho ALL thaw else did you hear about this position opening? (please check t apply)
EdCC employee Friend Posted announcement (where): ___________________________
Search engine (Google, EdCC w Periodical (which one): ___________________________ etc.) eb page
Newspaper (which one): ____ Other (please be specific): ___________________________________________________ _____
APPLICATION FOR
EMPLOYMENT
EDUCATION AND TRAINING (please list most recent first)
Have you graduated from high school or received a GED? Yes No
Universities or Colleges Dates
(From/To)
Credits Earned
(Semester/Qtr)
Degrees Earned Major
Other Schooling/Training (please include
military or other skills training)
Dates
(From/To)
Type of Training and/or Skills Learned
Do you hold a vocational instructor’s certificate? Yes No If yes, from which state?
Business machines you can operate:
Ten-key adding machine Calculator
Computers (please list): Software (please list):
________________________________ ________________________________
________________________________ ________________________________
________________________________ ________________________________
________________________________ ________________________________
Please list any professional licenses you hold that are required or applicable to the position (e.g., driver’s license, CPA, State Bar Association,
CDA, CDL, etc.).
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
EMPLOYMENT HISTORY (please list present or most recent employer first)
Position Title Duties
Firm Name
Street Address
City State Zip
Supervisor’s Name/Telephone
Dates of Employment (mo/yr) From To Assigned Hours/Week
Reason for Leaving Ending Salary
Position Title Duties
Firm Name
Street Address
City State Zip
Supervisor’s Name/Telephone
Dates of Employment (mo/yr) From To Assigned Hours/Week
Reason for Leaving Ending Salary
Position Title Duties
Firm Name
Street Address
City State Zip
Supervisor’s Name/Telephone
Dates of Employment (mo/yr) From To Assigned Hours/Week
Reason for Leaving Ending Salary
Position Title Duties
Firm Name
Street Address
City State Zip
Supervisor’s Name/Telephone
Dates of Employment (mo/yr) From To Assigned Hours/Week
Reason for Leaving Ending Salary
EMPLOYMENT HISTORY (continued from previous page)
Position Title Duties
Firm Name
Street Address
City State Zip
Supervisor’s Name/Telephone
Dates of Employment (mo/yr) From To Assigned Hours/Week
Reason for Leaving Ending Salary
Position Title Duties
Firm Name
Street Address
City State Zip
Supervisor’s Name/Telephone
Dates of Employment (mo/yr) From To Assigned Hours/Week
Reason for Leaving Ending Salary
Position Title Duties
Firm Name
Street Address
City State Zip
Supervisor’s Name/Telephone
Dates of Employment (mo/yr) From To Assigned Hours/Week
Reason for Leaving Ending Salary
Position Title Duties
Firm Name
Street Address
City State Zip
Supervisor’s Name/Telephone
Dates of Employment (mo/yr) From To Assigned Hours/Week
Reason for Leaving Ending Salary
PROFESSIONAL HISTORY VERIFICATION
Have you ever:
Been non-renewed or dismissed from a previous position? Yes No
Been asked to resign from a position? Yes No
Had a teaching, administrative or other professional license suspended or revoked? Yes No
Been subject to an investigation for employee misconduct or harassment? Yes No
Resigned in lieu of termination? Yes No
Explanation of “yes” responses:
CONFLICTS VERIFICATION
Are you currently related to or live as the domestic partner with any current employee of Edmonds Community College? Yes No
If so, please identify what College Department/Division they work in and who their direct supervisor is:
If you do not know or cannot find this information out, please identify the employee:
APPLICANT’S CERTIFICATION AND AGREEMENT
Please read carefully
I hereby certify that the information provided in this application is true and complete, and that there are no willful misrepresentations in and no
falsification of any of the statements and answers to questions. I am aware that should investigation disclose any misrepresentations of
falsifications, such disclosure will constitute grounds for rejection of application or immediate dismissal.
I hereby consent to and authorize any of my former employers to furnish any and all relevant information concerning my previous employment
record. I hereby consent to and authorize any of my previous educational institutions to furnish any and all relevant information concerning my
previous educational record. I release all parties connected with any request for information from all claims, liability, and damages for
whatever reason arising out of furnishing this information. If employed, I release Edmonds Community College from any liability for future
references it may provide regarding my work history at Edmonds Community College.
A photocopy of this release shall have the same effect as the original.
I understand that my employment is contingent upon proof of employment authorization and of identify and will present the documents when
asked.
I understand that should my position have unsupervised access to children under sixteen years of age or developmentally disabled persons I
will consent to a background investigation to check all information contained in or related to my application, including records of law
enforcement agencies. If I am employed, I understand that employment will be on a conditional basis pending completion of the background
check. I understand that should investigation disclose misrepresentation or omission, such disclosure will constitute grounds for rejection of
application or immediate dismissal.
I understand that I am responsible to Edmonds Community College for the replacement value of any College property that I retain beyond my
exit date. I hereby authorize the College to deduct from my final paycheck any monies that I owe the College. If the balance of my final
paycheck is not sufficient, I understand that the balance owed is a legal obligation. I agree that the College has the right to collect the balance
owed.
________________________________________________ _______________________________
Applicant’s Signature Date
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Edccapplication 000 (Edmonds Community College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 25 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document