E4946 Jackson Road
Ironwood, Michigan 49938
www.gogebic.edu
(906) 932-4231 or (800) 682-5910
APPLICATION FOR EMPLOYMENT
PERSONAL DATA
Name
Date
Address
Phone
Position Desired
Date you can start
Are you presently employed?
EDUCATIONAL BACKGROUND
Name & Location
Dates Attended
Degree
Majors
High School
College(s)
Other
WORK EXPERIENCE - REFERENCES (List last four employers, starting with most recent)
Dates Worked
Name & Address
Position
Salary
Reason for Leaving
From
To
From
To
From
To
From
To
REMARKS (Other experiences or additional information may be added here or included in resume)
Please note:
Official college transcripts mailed from each college and/or university attended must be received by Gogebic
Community College prior to hiring of all administrative and insctructional candidates.
I CERTIFY THAT THE INFORMATION PRESENTED IN THIS JOB APPLICATION AND SUPPORT MATERIAL IS TRUE
AND IF FOUND TO BE OTHERWISE AFTER EMPLOYMENT WILL CONSTITUTE CAUSE FOR DISMISSAL.
Signature of Applicant
IT IS THE POLICY OF GOGEBIC COMMUNITY COLLEGE NOT TO DISCRIMINATE ON THE BASIS OF RACE, SEX, AGE, COLOR, NATIONAL ORIGIN OR
ANCESTRY, MARITAL STATUS, OR VIETNAM ERA VETERAN STATUS IN ITS EDUCATIONAL PROGRAMS, ACTIVITIES, ADMISSIONS OR EMPLOYMENT
POLICIES AS REQUIRED BY TITLE IX OF THE 1972 EDUCATION AMENDMENTS, SECTION 504 OF THE REHABILITATION ACT OF 1973, AND THE
AMERICANS WITH DISABILITIES ACT OF 1990.
RELEASE
To Whom It May Concern:
This will authorize Gogebic Community College to obtain information from past and present employers and educational
institutions about my work performance and academic pursuits at the businesses and colleges/universities listed in my personal
resume and/or job application.
A photocopy of this authorization is deemed as valid a request as the original bearing my signature.
Signature
Date
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