Continu
ing Education Center
Illinois Valley Community College
815 N. Orlando Smith Road
Oglesby, Illinois 61348
Application Form for Non-Credit Instructor (type or print legibly)
Full Legal Name: _______________________________________________________________________
Mailing Address: _______________________________ City ____________ State _____ Zip __________
Home Phone: __________________________________ Cell Phone _____________________________
Work Phone: __________________________ Email Address: ___________________________________
Work Experience (last five years, begin with most recent)
Dates
Name & Location of Employer
Nature of Work Duties
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Education (include specialty training, high school, college, or vocational training)
School & Location Dates Degrees, if any Major or content of training
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Professional, social, volunteer groups and societies you belong to
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Name Company Name Daytime Phone Email
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Please indicate which position you are applying for. List any community education courses you feel
qualified to teach as well as any other details you would like us to know about you.
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Return Application To:
Office of Continuing Education & Business Services
Illinois Valley Community College
815 N. Orlando Smith Road
Oglesby, Illinois 61348
Illinois Valley Community College is an equal opportunity/affirmative action employer
List 2-3 Professional References