JOB APPLICATION
PROFESSIONAL APPLICATION FORM
Southeast Technical College
2320 North Career Avenue
Sioux Falls, SD 57107
Phone: 605-367-8355
Fax: 605-367-4372
TDD: 605-367-4374
General Information
Full Name: ______________________________________________________________________________
First Middle Last
Social Security Number: ________________________Email: _____________________________________
Current Address: _________________________________________________________________________
Address City State ZIP Code
Permanent Address: ______________________________________________________________________
Address City State ZIP Code
Telephone: ___________________________________ Mobile: ____________________________________
Federal law obligates us to provide reasonable accommodation to the known disabilities of applicants,
unless to do so would pose an undue hardship. Please feel free to let us know if you need an
accommodation to complete the application process.
For Position of
Instructor ____________________________________ Other _____________________________________
(Instructor applications must include copies of transcripts, credentials, certificates and other documents
relative to the professional qualifications of the position.)
Expected Salary $ _____________________________ Hourly Salary
Date Available to Start _________________________
Complete Applications will be screened for candidacy. If candidacy status is met, the application will be
retained in our active files for three months upon its completion. Please notify Southeast Technical College
of changes in name, address or phone number.
_________________________________________________________________________________________
_________________________________________________________________________________________
Academic History
High School
High School Name Address
College and Universities - List most recent first
College Name
Address
Address, City, State, Zip Code
Dates Attended
From-To
Degree Minors(s)
College Name
Address
Address, City, State, Zip Code
Dates Attended
From-To
Degree Minors(s)
College Name
Address
Address, City, State, Zip Code
Dates Attended
From-To
Degree Minors(s)
College Name
Address
Address, City, State, Zip Code
Dates Attended
From-To
Degree Minors(s)
Specialized Training
List all Licenses, areas of Certification or any other Special Training:
South Dakota Teaching Certification Information:
Do you have a SD Secondary Certificate? Yes No
If not, have you applied? Yes No
Do you have a Post-Secondary Credential? Yes No
Employment History
Employer
Address
Address, City, State, Zip Code
Dates Employed
From-To
Job Title
Salary
Start & End
Supervisor Name Full or Part Time
Full Time Part Time
Work Performed/Skills Used:
Reason for Leaving:
Employer
Address
Address, City, State, Zip Code
Dates Employed
From-To
Job Title
Salary
Start & End
Supervisor Name Full or Part Time
Full Time Part Time
Work Performed/Skills Used:
Reason for Leaving:
Employer
Address
Address, City, State, Zip Code
Dates Employed
From-To
Job Title
Salary
Start & End
Supervisor Name Full or Part Time
Full Time Part Time
Work Performed/Skills Used:
Reason for Leaving:
Employment History (continued)
Employer
Address
Address, City, State, Zip Code
Dates Employed
From-To
Job Title
Salary
Start & End
Supervisor Name Full or Part Time
Full Time Part Time
Work Performed/Skills Used:
Reason for Leaving:
References
These references should be from individuals who are or have been familiar with your professional work, and
who are qualified to answer questions concerning this application. Include at least one supervisor who has
evaluated you.
Name Phone Number Current Position
Years
Known
Relationship to
Applicant
Name Phone Number Current Position
Years
Known
Relationship to
Applicant
Name Phone Number Current Position
Years
Known
Relationship to
Applicant
Name Phone Number Current Position
Years
Known
Relationship to
Applicant
________________________________________________________________________________________
Legal Information
Are you eligible to work in the United States? Yes No
Have you ever been convicted of a felony? Yes No
If so, identify __________________________________________________________________________
Have you ever been discharged from a position? Yes No
If so, identify __________________________________________________________________________
Are you currently a party to a pending lawsuit or administrative action? Yes No
If so, identify __________________________________________________________________________
Veterans’ Preference
Check this box if you wish to claim veterans’ preference. To receive veteran’s preference, you must
meet the requirements of state law and you must attach your DD214 (separation papers). State law requires
residency in South Dakota to be eligible for veterans’ preference.
Place of residency if dierent from mailing address:
Address City State ZIP Code
The Sioux Falls School District is an equal opportunity employer providing opportunities for employment without regard
to race, color, creed, religion, age, gender, disability, national origin or ancestry. Inquiries concerning the application of
Title IX, Section 504 or Title VI, or the Americans with Disabilities Act of 1992 may be referred to the Assistant
Superintendent-Human Resources/Administrative Services at 201 East 38th Street, Sioux Falls, SD 57105-5898,
(PH: 605-367-7816, TDD: 605-367-7948), or to the U.S. Department of Education, Oce for Civil Rights, 10220 North
Executive Hills Blvd., Kansas City, MO 64153-1367, (PH: 816-880-4202; TDD: 816-891-0582; FAX: 816-891-0644).
Authorization
I authorize the Sioux Falls School District to make any investigation of any personal, educational,
vocational, or employment history. I further authorize any current or former employer, person, firm,
corporation, educational or vocational institution or government agency to provide the Sioux Falls
School District with information they have regarding me. I hereby release and discharge the Sioux Falls
School District and those who provide information from any and all liability as a result of furnishing and
receiving this information. I further agree that falsification of any part of this application, including any
accompanying inserts, shall be sucient cause for dismissal. References and personal information which
become a part of this application will be regarded as confidential and shall not be revealed to me.
Further, I understand the Sioux Falls School District is drug free/smoke free/tobacco free and that any
oer of employment is conditional based upon a completed criminal background check.
Signature ___________________________________________________ Date ____________________
WWW.SOUTHEASTTECH.EDU
Updated: July 30, 2020