GENERAL INFORMATION. The information can be typed or printed. Are you currently employed? Yes > No > May we contact your employer?

Transcription

1 WESTERN TECHNICAL COLLEGE JOB APPLICATION At Western Technical College we consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, citizenship, disability, or any other legally protected status. Position you are applying for: GENERAL INFORMATION The information can be typed or printed Referred by: Today s Applicant s Name: Last-First-Middle Address: Street-City-State-Zip Home Phone: Mobile Phone: SSN Have you filed an application here before? Yes > No > Have you been employed here before? Yes > No > Do you have any relatives employed by this company? Yes > No > Name: Are you currently employed? Yes > No > May we contact your employer? Yes > No > Are you legally entitled to work in the United States? Yes > No > Proof will be required upon employment What date will you be available for work? You are available to work Full Time > Part Time > Temporary > Can you travel, if the job requires it? Yes > No > Have you ever been convicted of a felony, misdemeanor, or deferred adjudication of guilt, other than minor traffic offenses? (conviction won t necessarily disqualify applicant from employment) If yes, please explain below: Yes > No > Please indicate which language(s), other than English, you speak, read and/or write: Fluent Good Fair Speak Read Write Rev 04/12 1

2 List professional, trade, business or civic activities and offices held: List 3 references who are not related to you and are not previous employers: Name: Address: Phone # EDUCATION Studies Name Location Dates Attended Elementary School: Middle School: High School: College/Technical: College/Technical: Studies Credential Received Subjects of special study: WORK HISTORY (Please list most current, and work backwards) Employer: Rev 04/12 2

3 Employer: Employer: If there is not a Job Description attached to this application, do not answer the following question: Can you perform the essential functions of this job as described in the attached Job Descriptiion with or without reasonable accommodations? (please check one of the following:) I need accommodations I do not need any accommodations I need to see the work site before I can answer this question Rev 04/12 3

4 Did you sign and date the attached Job Description? Yes > No > Special Skills and Qualifications Summarize special skills and qualifications that you have acquired from employment or other experience: List any business/office machines/equipment you can operate: I understand and agree that: I hereby certify that the information provided herein is true, correct and complete to the best of my knowledge and belief. Any material misrepresentation or deliberate omission of a fact in my application may be justification for refusal of employment, or if employed, termination of my employment. It is my understanding that Western Technical College will make a thorough investigation of my work history and may verify through reference checks and/or criminal background information of all data given in my application for employment, related papers, or oral interviews. I authorize such investigation and the giving and receiving of any information requested by Western Technical College and I release from liability any person or company giving or receiving such information. I understand that falsification of data so given or other derogatory information discovered as a result of this investigation may prevent my being hired, or if hired, may subject me to immediate dismissal. Although management makes every effort to accommodate individual preference, business needs may, at times, make the following conditions mandatory: overtime, shift work, or change of work schedule. I understand and accept these as conditions of my continued employment. I understand that if I receive an offer of employment at Western Technical College, it will be contingent upon: A negative drug screen test result and my agreement to submit such test as a condition of continued employment. Pursuant to its Drug/Alcohol free program, WTC may conduct a reasonable search of an employee and/or his/her work area, locker, vehicle if driven or parked on school property, and other personal items. Continued employment is contingent upon my submission to a reasonable search which may also include testing of my hair, blood, or urine. The presentation of original documents establishing my identity and employment eligibility, and completion of INS Form I-9, as required by Federal Laws and Regulations. I further understand that this is an application for employment and that no employment contract is being offered or implied. Rev 04/12 4

5 I understand that if I m employed, such employment is for no definite period of time and that Western Technical College can change wages, benefits, and conditions at any time. In consideration of my employment, I agree to conform to the rules and regulations of Western technical College. Employment with Western Technical College is on an at will basis and as such may be terminated at any time by either employee or the company with or without cause. Any statement or promise to the contrary made by any employee or agent of Western Technical College is invalid and non-binding on Western Technical Institute unless made in writing and signed by the President of Western technical College. I have read, understand and do agree to all of the above. Name: Signature: Rev 04/12 5