APPLICATION FOR EMPLOYMENT
APPLICATION FOR EMPLOYMENT
WESTERN OKLAHOMA STATE COLLEGE
2801 North Main
Altus, Oklahoma 73521
Name (Last First Middle) Social Security Number
Address:
Street City State Zip
( ) ( )
Telephone Number Business Phone Citizenship
Position (Subject) Desired Email Address
EDUCATIONAL DATA
Graduated? Yes No
High School Attended
Address of High School City State Zip Code Year Graduated
Bachelor Yes No
College or University Attended Completed?
Address of University City State Zip Code
Total Undergraduate Hours Degree Date Completed
Major Hours in Major Minor Hours in Minor
Master
Degree Yes No
College or University Attended Completed
Address of University City State Zip Code
Total Hours at Master Level Degree Date Completed
Major Hours in Major Minor Hours in Minor
Thesis Title
Doctoral
Degree Yes No
College or University Attended Completed
Address of University City State Zip Code
Total Hours at Doctoral Level Degree Date Completed
Major Hours in Major Minor Hours in Minor
Dissertation Title
Have you attended a Community/Junior College or completed a course(s) in Community/Junior College Education? If so, please identify the institution and elaborate.
Graduated? Yes No
College Attended
Address of College City State Zip Code
Total Hours Degree Date Completed
PROFESSIONAL WORK EXPERIENCE
(Start with present position)
1.
Employer’s Name Address City State Zip Code
( ) From: to:
Telephone Number Position Title Dates of Employment
Duties of Position:
2.
Employer’s Name Address City State Zip Code
( ) From: to:
Telephone Number Position Title Dates of Employment
Duties of Position:
3.
Employer’s Name Address City State Zip Code
( ) From: to:
Telephone Number Position Title Dates of Employment
Duties of Position:
ADDITIONAL WORK EXPERIENCE
Employer’s Name Address City State Zip Code
( ) From: to:
Telephone Number Position Title Dates of Employment
Duties of Position:
List special job-related skills, honors and interests:
Honors and/or awards:
Professional Affiliations:
Publications:
Institutes and Special Training Courses:
REFERENCES
(At least two of the three references should be professional)
Name Address City State Zip Code
( )
Telephone Number Position Work Relationship
Name Address City State Zip Code
( )
Telephone Number Position Work Relationship
Name Address City State Zip Code
( )
Telephone Number Position Work Relationship
Please add any information you desire which supplies greater detail or would be helpful in our evaluation of your qualifications and credentials.
NOTE: Official transcripts of all college and university work should accompany this application.
|To the best of my knowledge, the information herein is true and complete. I |This Institution in compliance this Title VI of the Civil Rights Act of 1964, |
|authorize Western Oklahoma State College to verify any or all information given |Executive Order 11246 as amended, Title IX of the Education Amendments of 1972 |
|and understand that falsification of this application will be grounds for |and other federal laws and regulations, does not discriminate on the basis of |
|dismissal if employed. I authorize previous employers, references or any other |race, color, national origin, sex, age, religion, handicap or status as a veteran|
|person to whom the College may refer, to provide information concerning me |in any of its policies, practices or procedures, this includes but is not limited|
|personally or my previous employment. |to admissions, employment, financial aid and educational services. |
| | |
|Employment at WOSC is “at will” and therefore is not guaranteed and may be | |
|terminated at any time by the employee or the employer without notice, reason or | |
|cause. | |
Signature of Applicant Date
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