Full-Time Employment Application

Employment Form

Full-Time Employment Application

Page 1 of 5

Platt College 303-369-5151

3100 South Parker Rd.

Aurora, Colorado 80014

Name: ______Telephone: ______

Address: ______Additional Telephone:______

______Email Address: ______

Date: ______Position Sought: ______

Education/Training/Certifications/Licensures

Other names that might be indicated on your college transcript______

Experience

Please use a separate block for each position. Begin with your current position. Briefly explain the principal duties performed in prior positions. Account for all periods of employment and any employment breaks. If not currently employed, or have never been employed, please indicate in the position block(s) provided. Please use month, date, and year to show all work experience. This will ensure a valid evaluation of your total work experience.

Please use additional paper to include other previous employment if applicable.

Faculty Applicants Only

Are you willing to conduct a demonstration of your teaching skills during an interview, if requested?

□Yes

□No

Present /Current Employer Contact

Do you have any objections to your present or current employer being contacted prior to the time of interview?

□Yes

□No

Attachments

Applicants must attach a resume. Please complete the application form in full; “see resume” notations are unacceptable.

Transcripts

Applicants must submit transcripts of all college and university work completed. Unofficial transcript copies may be submitted for screening purposes.

Employment Eligibility

Do you have proof of identity and employment eligibility in the United States?

□Yes

□No

Applicant ADA Accommodation Requests

The College will make a reasonable effort to accommodate persons with disabilities in the application and/or interview process.

Certification of Application

I hereby certify that all information contained in this application is true, complete and accurate to the best of my knowledge. I also authorize reference checks, the release of transcripts, and other personal information relative to my employment. I understand that any misstatement/misrepresentation or concealment of material facts or information may subject me to disqualification from competition for any position or termination of employment.

______

SignatureDate

Please address all correspondence concerning employment to:

Employment Inquiry

Platt College

3100 S. Parker Rd.

Aurora, Colorado 80014

303-369-5151

303-745-1433 (fax) or by email to

Supplemental/Voluntary Information (Optional)

Please type or print

The following information is complied to assist in the filing of required reports for statistical purposes. Completion by the applicant is strictly voluntary. This form is not part of the official application for employment and will not be used in any hiring decision. Your application will be processed whether or not you complete these questions or not. This form will enable the appropriate personnel at Platt College to more effectively evaluate the recruitment process in meeting affirmative action goals, and to determine if there is any adverse impact in the selection process on groups protected under federal and state equal opportunity laws. It will be retained in the office of the Director of Financial Services/MIS in a file separate from this application.

Position Applied For______Date______

City, State, Zip Code______

Gender: □ Male□ Female

Check one of the following to designate race/ethnic origin:

□ African American/Black□ American Indian

□ Asian□ Alaska Native

□ Hispanic or Latino□ White, non Hispanic

□ Two or more races□ Native Hawaiian or other Pacific Islander

Job Source Information

Please indicate where you learned of this job vacancy:

□ Newspaper (please specify) ______

□ Job Flyer Post

□ Professional Journal or Publication (please specify) ______

□ College Website

□ Friend, Colleague, Relative, etc.

□ Other (please specify) ______

PLEASE DO NOT PLACE YOUR NAME ON THIS FORM

Platt College does not discriminate on the basis of gender, sexual orientation, race, color, religion, age, mental or physical disability, veteran status or national origin in educational and employment opportunities, and is committed to the education of a non-racially identifiable student body.