Sandersville Technical College

1189 Deepstep Road
Sandersville, GA 31082
Phone: 478-553-2056

FOR EMPLOYMENT
Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status or veteran status or disability.
     
FULL TIME PART TIME DATE OF APPLICATION: 28-Aug-2008
     
POSITION APPLIED FOR: * required
NAME:

 Last
*		 First
*		 Middle
  
         
ADDRESS:
 Street Address
 City
 State
Zip
   
PHONE NUMBER: SOCIAL SECURITY NUMBER:

Yes No   Have you ever been employed here before? *
Yes No   Are you a citizen of the United States? *
Yes No   If not, do you have authorization to work in the U.S.? *
Yes No   Have you been convicted of a felony in the last seven years? *
      (Such a conviction may be relevant if job-related, but does not bar you from employment.)
      If yes, please explain:
 
EDUCATION High School College/Technical Graduate Professional
School Name
and Address
Years Completed
Diploma/Degree
Describe Specialized Training, Skills, or Competencies

LIST ANY PROFESSIONAL LICENSES HELD:

 

EMPLOYMENT EXPERIENCE (You may attach a resume in lieu of completing this section)
LIST EACH JOB HELD. START WITH YOUR PRESENT OR LAST JOB. INCLUDE MILITARY SERVICE.

Employer:

Address:


Direct Supervisor

Job Title:

 Dates Employed:

From:
    To:

Salary:

Starting $
    Final $

Work Performed:
Reason For Leaving:
Employer:

Address:


Direct Supervisor

Job Title:

Dates Employed:

From:
    To:

Salary:

Starting $
    Final $

Work Performed:
Reason For Leaving:
Employer:

Address:


Direct Supervisor

Job Title:

Dates Employed:

From:
    To:

Salary:

Starting $
    Final $

Work Performed:
Reason For Leaving:

Do you now hold or have you ever held a professional teaching certificate or a teaching permit in the State of Georgia?

If yes, complete the following:

Type:
Effective Dates:
Field:
Number:
Retirement Number:

REFERENCES

List the names of three persons who are not related to you, and who have definite knowledge of your qualifications for the position for which you are applying. Be sure to include your former administrators if you have teaching/administrative experience.

Name Company Title Telephone

EMERGENCY CONTACT INFORMATION

form fields here

RESUME UPLOAD

You must upload your resume as a file attachment to this completed form.
Resume to upload: * required

You may also upload a cover letter as a file attachment to this completed form.
Cover Letter to upload:
Non-Discriminatory Statement

Sandersville Technical College is an Equal Opportunity Institute. It is the policy of Sandersville Technical College to provide equal opportunities without regard to race, color, creed, national or ethnic origin, gender, religion, disability, age, disabled veteran, veteran of the Vietnam Era, or citizenship (except in those special circumstances permitted or mandated by law) to its programs and activities. “No qualified individual with a disability shall, on the basis of disability, be excluded from participation in or be denied the benefits of the services, programs, or activities of a public entity, or be subjected to discrimination by any public entity.� This includes, but is not limited to admissions, educational services, financial aid, and employment.

The following individuals have been designated as responsible for coordinating these efforts:

Equity Coordinator: Director of Student Services - Johnnie Edge, 478-553-2124, Room 204B
Campus Security Coordinator: Vice President of Administrative Services-Rosemary Burgamy, 478-553-2055 Room 101
EOE Coordinator (Employees): Human Resource Coordinator - Sharon J. Veal, 478-553-2056, Room 102

Inquiries concerning the application of these policies and procedures may be directed to the individuals listed above at:

Sandersville Technical College
1189 Deepstep Road
Sandersville GA 31082
478-553-2050

Sandersville Technical College is accredited by the Commission of the Council on Occupational Education. Requests for additional information on the policies, standards, or procedures of the Commission of the Council on Occupational Education may be addressed to:

Dr. Harry L. Bowman
Executive Director
Commission of the Council on Occupational Education
41 Perimeter Center East, N.E. Suite 640 Atlanta, GA 30346
770-396-3898

Sandersville Technical College is a unit of the Georgia Department of Technical and Adult Education.
 

CERTIFICATION - READ CAREFULLY BEFORE SIGNING

I certify that all information on this application is correct. I understand that intentionally providing false information on this form or attachment is a violation of state law. I authorize any agent or employee of the state to verify this information and to release it to anyone who may consider me for appointment. I further certify that either: 1) I have not been convicted of a drug-related criminal offense, or, 2) If I have been convicted of a drug-related criminal offense, it has been more than three months since my first conviction, or more than five years since a second or subsequent conviction.

Signature: * required

I have read and accept the conditions of the above statement: Yes       No * required