Sias International University and Brenda Institute of Technology
Employment Application Form
Application for term beginning (Circle One): Fall Spring Year: ______
I am applying to (Circle One): Sias International University Brenda Institute of Technology Both schools Planned teaching period(Circle One): One year Two years Other
Personal Information:
Name: Last: __ First: _ Middle: ______Maiden: ______
Date of birth: Age: Gender: ___
Citizenship: Passport No.: __ Expiration Date: ______
Marital Status: Place of Birth: ______
Address:
Country:
Primary Phone: _ Work Phone (if applicable): ______
Primary Email: Fax (if applicable): ______
Secondary Email (if applicable): ______
Academic History:
From most recent, list colleges, universities, and diploma programs attended:
Institution: ______Location: ______
Dates of Attendance: __ Major: ______
Degree Received: ___ Date of Graduation: ______
Institution: ______Location: ______
Dates of Attendance: __ Major: ______
Degree Received: ___ Date of Graduation: ______
Current Employment Status(Circle One):
Employed Full-Time Employed Part-Time Studying Full-Time Unemployed Retired Sabbatical
Employment History (from most recent):
Organization / Firm: ______
Location:______Title/Position: ______
Dates of employment: Phone: ______
Organization / Firm:______
Location:______Title/Position:______
Dates of employment: Phone: ______
Employment Reference:
Name:______Organization:______
Position: ______
Phone: ______Email: ______
Do you have a TESOL certificate or TEFL training? (Circle One) Yes No
Have you taught in China before? (Circle One) Yes No
Have you ever been convicted of a criminal offense?(Circle One) Yes No
List any honors or scholastic achievements:
Please tell us how you heard about Sias University:
Please specify name(s), relationship, and age of dependents traveling with you to China:
Name Relationship Age
(1)
(2)
(3)
Please write a personal statement below,including two reasons why you want to teach in China.
Disclaimer and Conditions of Application
By signing below, I confirm that I understand that misrepresentation, falsification or omission of factual information requested on this job application form may be cause for disciplinary action which could result in dismissal. I also indicate my agreement to the following conditions:
- I acknowledge my application may not be accepted if I have not provided the requested information.
- I certify that the information on this form is true and correct and includes information that is relevant to the position I have applied for.
- I understand that the information I have given on this form and any subsequent information I may give Sias International University may be held on computer and remain so whether or not I become a Sias International University employee and/or after my employment has ended. I acknowledge that Sias International University applicant and employee data shall remain the property of Sias International University. I agree that the information may be controlled and processed electronically by Sias International University and may be used for research, human resource management and administrative purposes, and will be disclosed to various government departments for the purpose of processing an invitation letter, needed for the issuance of a “Z” working visa in the People’s Republic of China.
- I understand that I have the right of access to, and to ask for correction of, personal details about me held by Sias International University.
- I acknowledge that it may constitute grounds for termination should any of the above information be to my knowledge untrue or misleading, in the event I am offered employment with Sias International University.
- I understand that according to the exit and entry laws of China, anyone suffering from a mental disorder, leprosy, AIDS, venereal diseases or any other infectious diseases may not enter into the People’s Republic of China.
- I acknowledge that during the application process, I will be required to fill in a detailed medical questionnaire.
- I consent to Sias International University contacting references listed on this form or my resume.
Signature______Date ______
Please print, complete, and scan this application, then send it as an email attachment to . Please call Aaron Vorbau at 209-877-SIAS (7427) with any questions or to follow up with your application status.
Sias International University Tel: 86-371-62600860
168 People's Road East Fax: 86-371-62605536
Xinzheng City, Henan 451150 Website: academicsinasia.com
The People's Republic of China Email: