GROSSMONT-CUYAMACA COMMUNITY COLLEGE DISTRICT
This was created by Sharon in Pers. and e-mailed to us for a save number and some fixing. GROSSMONT-CUYAMACA COMMUNITY COLLEGE DISTRICT
Employment Services
8800 Grossmont College Drive, El Cajon, CA 92020-1799
APPLICATION FOR PART-TIME TEACHING POSITION
Applications remain active for one year from date of completion.
SUBJECT MATTER DISCIPLINE NUMBER(S) (refer to the attached discipline list)
If applying in more than one discipline, you must provide the original and a xerox copy for each.
NAME: DATE:
LAST First Middle
Mailing
Address:
No. & Street City State Zip
Business Telephone: ( ) Home Telephone: ( )
Soc. Sec. No. - -
SITE PREFERENCE: TIME PREFERENCE:
ο CUYAMACA COLLEGE ο DAY ο WEEKENDS
ο GROSSMONT COLLEGE ο NIGHT
ο BOTH ο BOTH
List California community college teaching credentials. Please provide copies. Expiration Date
Title: Major: Minor ________________ _____________
Title: Major: Minor: _____________
Title: Major: Minor: _____________
Community College courses best qualified to teach in order of priority: (include code from discipline list)
1. 4. _____________________________
2. 5. _____________________________
3. 6.
Specific areas of specialization or area of emphasis in academic major:
1. 2. 3. ____________________
EDUCATIONAL BACKGROUND
DEGREES AWARDED
| Colleges Attended | Location | Inclusive Dates | Degrees |
| |City & State |From-To |Major and Minor |
| | | |Fields of Study |
| | | | |
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-2-
TEACHING EXPERIENCE
| Name of School | Location | Inclusive | Subjects Taught | Full or |
| |City and State |Dates | |Part |
| | |From-To | |Time |
| | | | | |
| | | | | |
| | | | | |
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OTHER RELEVANT EXPERIENCE
(may include military service, volunteer work, and/or community service)
| Activity | Location | Inclusive | Paid or Unpaid |
| |City & State |Dates | |
| | |From-To | |
| | | | |
| | | | |
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RELEVANT COURSE WORK
| Course Title | Name of School | Inclusive | Degree Applicable? |
| | |Dates |Major or Minor Fields |
| | |From-To |of Study |
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I hereby certify that the statements above are true and complete to the best of my knowledge and belief. I understand
that any false statements on this application may be the cause for my termination in the event I am employed.
I consent to references and former employers being contacted regarding this application and understand that if I am employed I must furnish official transcripts and a fingerprint processing fee.
__________________________________________________ Signature of Applicant
Yearly renewal is necessary to keep this application active. 97-0466-002W rev. 05/03js
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