Fillable Scc Job Application (Shawnee Community College)

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Scc Job Application (Shawnee Community College)

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Country of origin: US
File type: PDF

U.S.A. forms for Shawnee Community College

BROWSE SHAWNEE COMMUNITY COLLEGE FORMS

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City State Zip
MISCELLANEOUS
Are you less than 18 years of age? ( ) Yes ( ) No
If yes, can you furnish a work permit? ( ) Yes ( ) No
Have you ever been employed by SCC before? ( ) Yes ( ) No
Have you filed an application with SCC within the past 12 months? ( ) Yes ( ) No
Are you legally permitted to work in the country? ( ) Yes ( ) No
If yes, will you be prepared to produce proof at the time of hire, in accordance with
the Immigration Reform and Control Act of 1986? ( ) Yes ( ) No
Are you currently receiving retirement benefits from the State Universities Retirement
System (SURS)? ( ) Yes ( ) No
If yes, you may be required to provide the following documentation from SURS:
1. Monthly earning limitation
2. Highest rate of earnings
Do you have any relatives working at SCC? ( ) Yes ( ) No
If yes, name of SCC employee _________________________________________
Are you currently employed by another SURS covered employer? ( ) Yes ( )No
If yes, please complete the following: (please add an additional sheet if necessary)
Employer Name
Number of Weeks Worked
or Anticipated to Work
Dates Worked or
Anticipated to Work
Estimate Gross Pay
for that Job/Position
PERSONAL DATA
Name: ____________________________________________________________
Last First Middle
Address: ______________________________ Home Phone: ________________
Street or Box Number
______________________________ Office Phone: ____________________
POSITION: ________________________________________________________
______ Full Time ______ Part Time ______ Temporary
Date of Application: ___________________ Salary Desired: __________________
EMPLOYMENT
APPLICATION
8364 Shawnee College Road
Ullin, IL 62992
www.shawneecc.edu
EDUCATION
Name/Position
Email Address
Telephone Number
School
Name/Address
of School
Degree/
Diploma
Awarded
Major
Hours
Earned
Toward
Cert./Degree
High
___Diploma
___GED
Certifcate
__Yes __ No
College
Masters
__Yes __No
College
Bachelors
__Yes __No
College
Associates
__Yes __No
Other Pertinent Formal Training, if any: ________________________________
_________________________________________________________________
_______________________________________________________________
Professional Organizations: _________________________________________
_________________________________________________________________
_______________________________________________________________
Academic Recognition or Awards: _____________________________________
_________________________________________________________________
_______________________________________________________________
PROFESSIONAL REFERENCES (List references who are not related to you and are not
previous employers)
EMPLOYMENT HISTORY: List in order last employer first.
Employer: ___________________________ Dates of Employment: _____________
Address:
___________________________________________________________________
Street City State Zip Code
Phone Number: _________________________ Position: _____________________
R Reason for Leaving: ___________________________
____ Voluntary ____ Involuntary
Supervisor: _________________ May be contacted for references ___ Yes ___ No
Employer: _____________________________ Dates of Employment: ___________
Address:
___________________________________________________________________
Street City State Zip Code
Phone Number: _________________________ Position: _____________________
Reason for Leaving: ___________________________
____ Voluntary ____ Involuntary
Supervisor: _________________ May be contacted for references ___ Yes ___ No
Employer: _____________________________ Dates of Employment: ___________
Address:
___________________________________________________________________
Street City State Zip Code
Phone Number: __________________ Position: ____________________________
Reason for Leaving: __________________________
____ Voluntary ____ Involuntary
Supervisor: _________________ May be contacted for references ___ Yes ___ No
Shawnee Community College is an Equal Opportunity/Affirmative Action
Employer.
READ CAREFULLY
I certify that all information provided in this employment application is true and
complete. I understand that any false information or omission may disqualify me from further
consideration for employment and may result in my dismissal if discovered at a later date. I
authorize and agree to cooperate in a thorough investigation of all statements made herein and
other matters relating to my background and qualifications. I understand that any investigation
conducted may include a request for employment and educational history, credit reports,
consumer reports, investigative consumer reports, driving record, and criminal history. I
authorize any person, school, current and former employer, consumer reporting agency, and
any other organization or agency to provide information relevant to such investigation and I
hereby release all persons and corporations requesting or supplying information pursuant to
such investigation from all liability or responsibility to me for doing so. I understand that I have
the right to make a written request within a reasonable period of time for complete disclosure of
the nature and scope of any investigation. I further authorize any physician or hospital to
release any information which may be necessary to determine my ability to perform the job for
which I am being considered or any future job in the event that I am hired.
I agree to abide by all rules and regulations in effect at the time of my employment or
subsequently initiated.
I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT
DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT
FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE
BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE
TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT
NOTICE.
I have read, and understand, and by my signature consent to these statements.
Signature of Applicant _______________________________ Date ________________
The college is strongly committed to equal opportunity and affirmative action in its
educational programs, as well as hiring of faculty and staff members. Because of our
commitment, it is important that we conduct a careful evaluation of our recruitment efforts
when openings become available within the institution.
In order to comply with federal laws and to assure our affirmative action objectives, we
must collect and analyze the information requested on the following form. We fully
realize that supplying the requested information is voluntary on your part. However, we
urge you to assist us in gathering this vital information. Safeguards have been instituted to
ensure that the information cannot be used as a basis for discrimination during hiring.
Your cooperation in supplying this information is greatly appreciated.
The information being provided below is for information and reporting purposes
only. This information will not be used for hiring purposes.
EQUAL OPPORTUNITY INFORMATION FORM
Position Applied For: _______________________________________________
Name: ________________________________ Age: _____ Sex: ___M ___ F
RACE/ETHNIC BACKGROUND:
_____ White, Non-Hispanic or Latino
_____ Black, Non-Hispanic or Latino
_____ Hispanic or Latino
_____ Native Hawaiian or Pacific Islander (Not Hispanic or Latino)
_____ Asian (Not Hispanic or Latino)
_____ American Indian or Alaskan Native (Not Hispanic or Latino)
_____ Two or More Races (Not Hispanic or Latino)
VETERAN STATUS: Are you a disabled veteran? ___ Yes ___ No
Vietnam Era veteran? ___ Yes ___ No
How did you hear of this position? _____________________________________
(If through an advertisement, please name the publication in which is appeared)
_____________________________________
Thank you for your assistance.
Shawnee Community College is an Equal Opportunity/Affirmative Action Institution. Women and
minorities are encouraged to apply.
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Scc Job Application (Shawnee Community College)

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Completed 3 February 2021

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