SWTC Employee Application

SWTC
SOUTHWEST TECHNOLOGY CENTER W. TAMARACK
ALTUS, OK 73521
580-477-2250 580-477-0138 www.swtech.edu
APPLICATION FOR EMPLOYMENT
EQUAL EMPLOYMENT OPPORTUNITY POLICY
Southwest Technology Center District No. 27 is in compliance with Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title IX of he Education Amendment of 1972, and other federal laws and regulations, and does not discriminate on the basis of race, color, handicap, or status as a veteran in any of its practices, policies or procedures. This includes, but is not limited to admissions, employment, financial aid, and educational services.
Position Applied for
Date of Application

MonthDayYear
Date
When are you available for Employment
Acceptable Minimum Salary
Referral Source

AdvertisementFriendRelativeAgencyOther
PERSONAL DATA
Last Name
First Name
Social Security Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Have you filed an application here before?

NoYes
If yes, when?

MonthDayYear
Date
Have you ever been employed here before?

NoYes
If yes, when?

MonthDayYear
Date
Are you available to work?

Full-TimePart-TimeShift Work - YesShift Work - No
Are there any periods during the year when you will not be available to work?
Have you been convicted of a felony within the last 7 years?

NoYes
If yes, explain
EDUCATION

Type a question

	School Name And Location (City & State)	Dates attended (From - To)	Year Graduated	Type of Certificate, Diploma, Degree & Major
High School
College or University
Secondary School, Apprenticeship, or other Technical Training Programs

EMPLOYMENT EXPERIENCE
List each position held, beginning with your present or most recent position. Work back through previous positions and include military experience. Continue on a separate sheet of paper if you need additional space.
Date Employed From:

MonthDayYear
Date
Date Employed To:

MonthDayYear
Date
Name and Address of Employer
Summary of Work
Job Title
Supervisor
Reason for leaving
Date Employed From:

MonthDayYear
Date
Date Employed To:

MonthDayYear
Date
Name and Address of Employer
Summary of Work
Job Title
Supervisor
Reason for leaving
Date Employed From:

MonthDayYear
Date
Date Employed To:

MonthDayYear
Date
Name and Address of Employer
Summary of Work
Job Title
Supervisor
Reason for leaving
Summary of Employment Experience
Total years experience in education (teaching, Administrative or Supervisory)
Total years experience in the position applied for
Total years experience in business, industry, agriculture, or military service related to your area of specialization
Teacher Certification and Licensing

If you presently hold any type of teacher or administrative in Oklahoma, please fill out the following questions:
Type
No.
Expiration Date

MonthDayYear
Date
Type
No.
Expiration Date

MonthDayYear
Date
Type
No.
Expiration Date

MonthDayYear
Date
Type
No.
Expiration Date

MonthDayYear
Date
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
Are you licensed or certified by any trade or profession?

YesNo
If yes, indicate kind of license or certificate:
Specific information regarding teaching certification may be obtained by writing to the Oklahoma Department of Career and Technology Education, 1500 West Seventh, Stillwater, OK 74074... 405-377-2000

Note: Attatch a copy of your official Teaching Certificate or License
Teaching Certificate or License

Cancelof
List any professional activities or other information that is pertinent to this application and the position applied for.
Reference 1 Name

First NameLast Name
Reference 1 Phone Number
Please enter a valid phone number.
Reference 2 Name

First NameLast Name
Reference 2 Phone Number
Please enter a valid phone number.
Reference 3 Name

First NameLast Name
Reference 3 Phone Number
Please enter a valid phone number.
Agreement:

I certify that answers given herein are true and complete to the best of my knowledge. The information is provided to acquaint the interviewer with my qualifications. I understand completion of this application does not constitute an offer of employment. I understand that false or misleading information given in my application or interview(s) may result in discharge. I further understand that I am required by all laws, policies, rules and regulations of the Board of Education of District 27, the Oklahoma Department of Career and Technology Education, and State of Oklahoma. I authorize you to refer to former employers or other to verify statements made.
Legal Signature of Applicant

Clear
Date

MonthDayYear
Date
Attach Resume and/or Cover Letter

Cancelof
AN EQUAL OPPORTUNITY-AFFIRMATIVE ACTION EMPLOYER
Should be Empty:

SWTC

ALTUS, OK 73521

APPLICATION FOR EMPLOYMENT

EQUAL EMPLOYMENT OPPORTUNITY POLICY

PERSONAL DATA

EDUCATION

EMPLOYMENT EXPERIENCE

Summary of Employment Experience

Teacher Certification and Licensing

AN EQUAL OPPORTUNITY-AFFIRMATIVE ACTION EMPLOYER