FACULTY EQUIVALENCY APPLICATION
APPLICANT’S NAME:
POSITION/POOL (including discipline):
INSTRUCTIONS: The information requested below is required of all candidates who do not possess the stated
minimum qualifications and are seeking consideration on the basis of equivalency. Candidates making application on
the basis of equivalency shall submit this form as well as all other materials specified under “Application
Procedures” on the job announcement. You may refer the reviewer of this application to specific documents included in your
application packet for further details as long as you have completed the information as requested below and you state exactly
where the information can be found in your packet (i.e. "see resume for further details" or "see application for further
details", etc.).You may attach additional pages supporting your responses below.
THE PROCESS: Your completed application packet will be forwarded to the selection committee for the position/pool listed above
for review. If the committee determines that your qualifications are deemed equivalent to the stated minimum qualifications,
the Department Chair will make a recommendation to the Academic Senate Equivalency Committee for review. If approved
by the Equivalency Committee, the final recommendation will be determined by the Superintendent/President on behalf of the
Board of Trustees. Please note: the completion of this application does not guarantee recommendation to the Equivalency
Committee for review or acceptance for equivalency.
[1] I am claiming equivalency because I do not possess the required: Education and/or Experience (please check one or both).
[2] Academic preparation: (if you are claiming equivalency because you do not possess the required Education, you must submit
transcripts of any college-level coursework, regardless of whether you consider it relevant). Please be specific regarding the
institution, course titles, unit value, and level of coursework (graduate, upper division, etc.). Transcripts and copies of course
descriptions should also be attached. If degree is anticipated, please indicate date of expected confirmation.
DEGREE: TOTAL UNITS COMPLETED :
DEGREE: TOTAL UNITS COMPLETED :
RELEVANT COURSEWORK:
RELEVANT COURSEWORK:
[3] Relevant professional/work experience: (teaching and non-teaching) that should be considered to determine equivalency. Please
attach a detailed description of the duties performed.
Employer Job Title
Dates of Employment
(month/year)
(a)
F/T P/T
(b)
F/T P/T
TOTAL YEARS OF RELATED EXPERIENCE (full and part-time combined):
[4] A
ny other relevant accomplishments that should be considered to determine equivalency. (This could include, but would not be
limited to research, publications, seminars, professional performance/exhibitions, honors/awards, etc.).
[5] S
pecialized skills, knowledge and abilities that should be considered to determine equivalency.
[6] Relevant memberships and/or organizational activities that should be considered to determine equivalency.
[7] P
lease write a narrative synopsis (not to exceed one page) of your education and experience that illustrates possession of
qualifications that are at least equivalent to the stated minimum qualifications.
I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE FOREGOING STATEMENTS AND CONTENTS OF DOCUMENTS PROVIDED BY ME ARE
COMPLETE, TRUE AND CORRECT, AND IF EMPLOYED, I UNDERSTAND THAT I MAY BE SUBJECT TO DISMISSAL IF THEY ARE FOUND TO BE
UNTRUE OR INCORRECT. I ALSO UNDERSTAND THAT IT IS MY COMPLETE RESPONSIBLITY TO PROVIDE ALL INFORMATION NECESSARY
TO BE CONSIDERED FOR EQUIVALENCY.
Signature _________________________________________________________________ Date _________________________
This document and any attachments will become part of a Personnel File if hired by Santa Rosa Junior College.
SRJC Human Resources Department • 1501 Mendocino Avenue, Santa Rosa, CA 95401 • Phone: 707/527-4954 • Fax: 707/527-4967 • www.santarosa.edu/hr
Revised 7/09
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