Employment Application

General Information

Specific Position Applied For:*
General Area(s) of Employment Interest:
Full-Time Instructor
Part-Time Adjunct Instructor
Other
When Are You Available for Employment?
Minimum Salary Acceptable:
Email Address:
First Name:*
Middle Name:
Last Name:*
Home Phone:
Business Phone:
Cell Phone:
Fax Number:
Present Address:*
City:*
State:*
Zip:*
Permanent Address:
Permanent Address City:
Permanent Address State:
Permanent Address Zip:
Have you filed an application here before?YesNo
If Yes, Date:
Have you ever been employed here before?YesNo
If Yes, Date:
Are there any time periods when you will not be available for work?YesNo
When?
Please explain your answer:
Have you been convicted of a felony within the last 10 years?YesNo
If yes, explain:

Education Experience

High School
School Name and Location:
No. of Years or Hours Completed:
Type of Certificate:
Military School(s), Apprenticeship or Other Technical Training Programs
School Name and Location:
No. of Years or Hours Completed:
Type of Certificate:
Please list any computer applications you can operate with proficiency:
College or University
School Name and Location:
No. of Years or Hours Completed:
Type of Certificate:
College or University (Second Degree)
School Name and Location:
No. of Years or Hours Completed:
Type of Certificate:
College or University (Third Degree)
School Name and Location:
No. of Years or Hours Completed:
Type of Certificate:

Employment Experience

List each position held, beginning with your present or most recent position. Work back through previous positions including military experience*. Continue on a separate sheet of paper if you need additional space.
May we contact your previous places of employment?YesNo
May we contact your current employer?YesNo

Employer #1:

Name of Employer:
Address of Employer:
Job Title:
Dates Employed From:

to

Salary:
Supervisor:
Phone:
Fax:
Employer's Email:
Summary of Work Performed:
Maximum 450 characters
Reason for Leaving:

Employer #2:

Name of Employer:
Address of Employer:
Job Title:
Dates Employed From:

to

Salary:
Supervisor:
Phone:
Fax:
Employer's Email:
Summary of Work Performed:
Maximum 450 characters
Reason for Leaving:
Summary of Work Performed:
Maximum 1098 characters

Employer #3:

Name of Employer:
Address of Employer:
Job Title:
Dates Employed From:

to

Salary:
Supervisor:
Phone:
Fax:
Employer's Email:
Summary of Work Performed:
Maximum 450 characters
Reason for Leaving:
Summary of Work Performed:
Maximum 1098 characters

Employer #4:

Name of Employer:
Address of Employer:
Job Title:
Dates Employed From:

to

Salary:
Supervisor:
Phone:
Fax:
Employer's Email:
Summary of Work Performed:
Maximum 450 characters
Reason for Leaving:
Summary of Work Performed:
Maximum 1098 characters

Professional References

Reference #1:

Name:
Address:
City, State, Zip:
Phone:
Fax:
Email:
How do you know this individual?

Reference #2:

Name:
Address:
City, State, Zip:
Phone:
Fax:
Email:
How do you know this individual?

Reference #3:

Name:
Address:
City, State, Zip:
Phone:
Fax:
Email:
How do you know this individual?

Reference #4:

Name:
Address:
City, State, Zip:
Phone:
Fax:
Email:
How do you know this individual?

Teacher Certification and Licensing

Do you presently hold any type of teaching or administrative certification in Oklahoma?YesNo
If you do not qualify for a Standard Teaching Certificate in Oklahoma, are you willing to work toward completion of the minimum requirements for your area of specialization?YesNo
If applying for a Bus Driver position, please list the type of CDL you hold and the applicable endorsements:
Are you licensed or certified by any trade or profession?YesNo
If yes, indicate kind of license or certificate:

Agreement

Please read carefully.

I hereby affirm that all statements made herein are true and correct. I authorize Southern Oklahoma Technology Center District #20 to conduct whatever investigation it deems necessary to confirm information given on this application and in any interview. I understand and agree that any false or misleading information given or omission of fact shall be sufficient grounds for summary dismissal.

I authorize and request each former employer and person, school, firm or organization given as references, to answer any and all questions that may be asked, and to give any and all information that may be sought in connection with this application. I also certify that any person, agent, school, firm or organization who may furnish such information concerning me shall not be held accountable for giving this information; and I do hereby release said person, agent, school, firm or organization from any and all liability as a result of furnishing such information.

I understand that certain positions may require that I undergo and successfully complete a post-offer of employment physical examination, drug test, and an Oklahoma State Bureau of Investigation (OSBI) and/or 3rd party vendor background check. These are required of all entering employees and any offer of employment, under these circumstances, will be conditioned upon the results.

I understand that the use of this application form does not guarantee that there are any positions available, and in no way obligates Southern Oklahoma Technology Center District #20.

I understand that acceptance of any offer of employment does not create a contractual obligation upon Southern Oklahoma Technology Center District #20 to continue to employ me in the future.

Should I be employed, I agree to support the Constitution and the laws of the United States of America and the Constitution and the laws of the State of Oklahoma and abide by all policies and procedures of Southern Oklahoma Technology Center District #20.

Legal Electronic Signature of Applicant:*
Date:

*Electronic Signatures in Global and National Commerce Act, a federal law, allows electronically signed documents to have the same legal integrity as documents bearing an ink signature..

This application will remain active 120 days.