Employment Application
Lussier Community Education Center is an Equal Opportunity Employer, AA/EOE
Employee Information
Full Name
*
First Name
Middle Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Position Information
Position Applied For:
*
Have you ever applied for employment with LCEC? If yes, provide month & year.
/
Month
/
Day
Year
Date
Have you been previously employed with LCEC? If yes, provide position title.
Professional References
Provide the name, email, and phone number for three references who are not related to you. Options could include previous supervisors, previous coworkers, mentors, colleagues, volunteer supervisors, friends, or teachers/professors.
Name - Reference 1
First Name
Last Name
Email - Reference 1
example@example.com
Phone - Reference 1
Please enter a valid phone number.
Format: (000) 000-0000.
Name - Reference 2
First Name
Last Name
Email - Reference 2
example@example.com
Phone - Reference 2
Please enter a valid phone number.
Format: (000) 000-0000.
Name - Reference 3
First Name
Last Name
Email - Reference 3
example@example.com
Phone - Reference 3
Please enter a valid phone number.
Format: (000) 000-0000.
Work Experience
LinkedIn (optional)
Upload Your Resume
*
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Cover Letter - Please express exactly why you are interested in this position and working at the LCEC. Describe to what extent your training and experience have equipped you with the technical knowledge, skill, and interest to perform the type of work you are applying for.
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If you are considered for employment with Lussier Community Education Center, Inc., you will be asked to fill out a Background Information Form. Wisconsin’s Fair Employment Law, s. 111.31 –111.395, Wisconsin Statutes, prohibits discrimination because of criminal record or pending charge, unless the record or charge substantially relates to the circumstance of the particular job or licensed activity. By selecting "I understand" you are verifying that you are aware of this.
*
I understand
I certify that all the information given on this application is true and complete to the best of my knowledge and agree that any false or missing information may disqualify me for this position. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
*
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Affirmative Action
Information requested for affirmative action use only and shall remain confidential. Completing this section of the application is completely optional. Lussier Community Education Center is an equal opportunity employer, which does not discriminate against individuals based on race, national origin, gender, physical disability, religion, sexual orientation, age, or any characteristics protected by law.
Name
First Name
Last Name
Do you consider yourself handicapped or disabled?
Yes
No
Gender
Agender
Cisgender - Female
Cisgender - Male
Genderqueer
Gender-Fluid
Gender Non-Conforming
Non-Binary
Transgender - Female
Transgender - Male
Other
Are you hispanic/latino?
Yes
No
Ethnic Group
American Indian or Native Alaskan
Asian
Black or African American
Native Hawaiian or Pacific Islander
Middle Eastern or North African
white
Mixed
Other
Signature
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