Fillable RIVER PARISHES COMMUNITY COLLEGE APPLICATION FOR STAFF POSITION (River Parishes Community College)

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RIVER PARISHES COMMUNITY COLLEGE APPLICATION FOR STAFF POSITION (River Parishes Community College)

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The RIVER PARISHES COMMUNITY COLLEGE APPLICATION FOR STAFF POSITION (River Parishes Community College) form is 3 pages long and contains:

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  • 19 check-boxes
  • 67 other fields

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File type: PDF

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Page 1
Staff Application, Revised: 12/3/2018
RIVER PARISHES COMMUNITY COLLEGE
OFFICE OF HUMAN RESOURCES
925W EDENBORNE PKWY, GONZALES, LA 70737, (225) 743-8500
APPLICATION FOR STAFF POSITION
This application must be completed in its entirety and a resume submitted in order for you to be considered for a staff
position at River Parishes Community College. Information contained in a resume or other attachment will not be
accepted in lieu of your completing this application. Official college/university transcripts sent directly from the
institution to RPCC will be required prior to final selection. Evidence of meeting the minimum qualifications must be
clearly stated on this application in order for you to be considered for employment with the College.
------------------------------------------------------------------------------------------------------------------------------------
Please print or type Today’s Date: ____________________ SSN ______________________________
Name: ____________________________________________________________________________________
Last First Middle
Address:__________________________________________________________________________________
Street City State Zip Parish/County
E-Mail Address: ____________________________________________________________________________
Home Phone:(____)________________ Work Phone:(____)________________ Cell: __________________
Position applying for:________________________________________________________________________
How were you referred for this position: Ad RPCC Employee Other: ____________________
Education:
Name and
Location of School
Dates of Attendance
Diploma, Degree of
Certification
Earned and Date
Degree Major Semester
Hours
Completed
From To
Mo. Yr. Mo. Yr.
College
College
College/Other
Page 2
Staff Application, Revised: 12/3/2018
List professional, business or industrial related certificates/credentials you hold:
________________________________________________________________________________________________
________________________________________________________________________________________________
Employment History:
1. Name of Employer:
Telephone:
Name & Title of Supervisor:
Address (City, State & Zip):
Employment
Dates:
From:
To:
Full-time __
Part-time __
Hours per week ____
2. Name of Employer:
Telephone:
Name & Title of Supervisor:
Address (City, State & Zip):
Employment
Dates:
From:
To:
Full-time __
Part-time __
Hours per week ____
3. Name of Employer:
Telephone:
Name & Title of Supervisor:
Address (City, State & Zip):
Employment
Dates:
From:
To:
Full-time __
Part-time __
Hours per week ____
Applicant EEO Data
The State of Louisiana requests the data below so we may comply with federal Equal Employment Opportunity Law
requirements. The information provided in no way influences employment prospects.
BIRTH DATE ________________________________
Female Male
Married Single
GENDER
MARITAL STATUS
RACE
ETHNICITY:
Hispanic Non-Hispanic
Other
Black/Non-Hispanic Asian/Pacific Islander American Indian/Alaskan
Page 3
Staff Application, Revised: 12/3/2018
___ Hispanic ___ White/Non-Hispanic ___ Other
Certification and Consent:
I hereby certify that all statements made in this application are true, and I agree and understand that any misstatement of material facts herein
may cause forfeiture on my part of all rights to any employment. I authorize River Parishes Community College to obtain
reference/background checks as needed. I also agree to not engage in the unlawful manufacture, distribution, dispensing, possession, or use of
a controlled substance or firearm while on college property or while conducting any activity involving the College.
_____________________________________________________________________________________________________________
Signature of Applicant Date
River Parishes Community College, a member of the Louisiana Community and Technical College System, is an affirmative action, equal opportunity employer.
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RIVER PARISHES COMMUNITY COLLEGE APPLICATION FOR STAFF POSITION (River Parishes Community College)

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Completed 26 July 2020

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