SLOCCD
P.O. Box 8106, San Luis Obispo CA 93403
(805) 546-3129 / Fax: (805) 546-3906
SLOCCD Short/Term-Temporary Employment Application
Position(s) for which you are applying:
PERSONAL INFORMATION:
Legal Name:
First Middle Last
Mailing Address:
Number, Street, Apt./Unit, PO Box City State Zip
Physical Address:
Number, Street, Apt./Unit City State Zip
Daytime Number: Cell Number:
Evening Number:
Email Address:
EDUCATIONAL TRAINING:
Name of School Location (City/State) Grades Completed Diploma
EXPERIENCE: List employment and experience during the past ten years only
Date: From/To Name & Address of Employer Duties Left Due To
Please attach your resume or curriculum vita
EMPLOYMENT REFERENCE: List three reference who have first-hand knowledge of you and your work.
Name Address, City & State Phone Number(s)
San Luis Obispo County Community College District is an equal opportunity employer and welcomes applications from minority applicants as well as women/men for
both traditional and non-traditional openings. I certify under penalty of perjury that the statements above are true and complete to the best of my knowledge. I waive
the right to hold liable those persons whom I have listed as employment references. Short-Term/Temporary position assignments are non-classified/non-academic
appointments not to exceed 175 working days per year. Assigned workdays and hours may vary. Employment is at will and may be terminated at any time. This
assignment does not qualify for fringe benefit coverage, paid vacation, or holiday. This assignment may qualify for sick leave.
Applicant’s Signature Date
IMPORTANT: The San Luis Obispo County Community College District requires that applicants are REQUIRED to fingerprint as a condition of
employment. Fingerprint will initiate a DOJ background check that must be reviewed and approved by the Vice President Human Resources or designee prior
to being allowed to work. In addition, within 60 days of employment, all employees are REQUIRED to submit a negative Tuberculosis Skin Test.
Please identify any relative (child, parent, spouse, or domestic partner, siblings, or in-law’s or step-relatives in the space provided below) currently employed
by SLOCCD. If you do not have a relative employed by SLOCCD please leave the space blank.
Applicants Initials
FOR DEPARTMENT USE ONLY:
FP Req: FP Comp:
TB Req:
TB Comp:
HPR:
Sent to HR: Init:
