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Position Applying for:
Are you currently qualified to perform, with or without accommodation, the essential duties of this position?
If you need accommodation for a physical or mental disability in order to perform the job, you must notify us in writing within 182 days after you know or should have known of this need, or you may lose certain rights under the Michigan Persons with Disabilities Civil Rights Act.
Full or Part time
Street Address line 2
State / Province / Region
Zip / Postal Code
Please Identify the best time to call
Are you legally eligible for employment in the U.S.?
Have you ever been convicted of or have you plead guilty to a crime?
Have you ever been disciplined, discharged or resigned to avoid discharge?
When would you be available for a personal interview?
When will you be available to begin work?
Are you currently employed?
Current position title
Are you on lay-off or subject to recall?
Have you ever been employed at this college?
Do you have any relatives who work at MCC?
EDUCATION - Secondary
In this text box, please list all Secondary Institutions that you have attended, Credits Earned for Each and any Certificates, Diploma's or Degrees that were received.
EDUCATION - College, University or specialized school
In this text box please list all Colleges, Universities, or specialized schooling. Please give Credits Earned and Certificate, Diploma or Degree Received
EDUCATION - Graduate Work
Please list the Institution(s), Credits Earned, and any Certificates, Diploma or Degree received
Instructional Applicants Only - List subject(s) you can teach in order of preference
Are you certified or certifiable to teach vocational courses?
Do you have a National Career Readiness Certificate?
Undergraduate: Major fields of study
Undergraduate: Minor fields of study
Graduate: Major fields of study
Graduate: Other fields of advanced study
Thesis subject: M.A. / PH.D.
CONTINUING EDUCATION - Education not included in the above for the purpose of keeping current in the field.
Professional Certificates or Licenses
Please list the Name of certificate or license, who it was conferred by and dates of issuance
Please list your last FOUR employers, starting with the most recent. We need Employer Name, Address, Phone number, From and To dates, your position Duties and the name of your Supervisor. We also need your reason for leaving ahd the highest salary that you obtained.
Comments (including explanation of any gaps in employment)
RELATED EXPERIENCES (Hobbies, travel, clubs and other activities related to the job you are seeking. Please do not list clubs or other activities that would disclose religions, race, national origin, disability, political affiliation or other legally protected information.
Why do you desire to be employed by Montcalm Community College?
REFERENCES: Business/Professional (use only living persons) List names, addresses and telephone numbers.
Please attach your cover letter and resume, transcripts and reference letters.
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SIGNATURE - By your submission of this application, you understand and agree to the following terms;
The facts set forth above in my application for employment are true and complete. I understand and agree that any false or misleading statements or omissions in this application shall be grounds for rejection or dismissal. I authorize Montcalm Community College to use its personnel or any investigative agency to investigate my personal and employment history, education and criminal conviction record. I also authorize all my employers and former employers, references, credit reporting agencies/bureaus, educational institutions and any other persons contacted by Montcalm Community College, including any disciplinary records, and waive any right to notice of such disclosure; and I release all parties who receive or provide such records or information from all liabilities arising from such disclosures. Applicants offered employment may be required to undergo a medical examination prior to starting work, which may include alcohol and/or drug testing. All employees are hired at-will and my be released without cause or notice, except as specifically modified by a written and signed contract or bargaining agreement. The undersigned also agrees any claim and or lawsuit against the College, its Board and its Trustees, its executives, employees, agents and/or representatives in their official and/or individual capacity arising during the application process, my employment with and/or separation of employment from the College shall be filed within 180 calendar days from the date the claim arises or be forever barred including without limitation all claims for civil rights, violations under Title VII and the Michigan Elliott-Larsen Civil Rights Act, Michigan Handicappers Civil Rights Act, Age Discrimination in Employment Act, Americans With Disabilities Act, violations of all other federal and state statues and common law, and state contract and tort law. I waive any statutes of limitations to the contrary.
APPLICANT DATA RECORD (ADR)
Position Applied For
MCC Website posting
Current MCC Employee
Former MCC Employee
Other website posting
ADR First Name
ADR Last Name
ADR Street Address
ADR State / Province / Region
ADR Zip / Postal Code
American Indian/Alaskan Native
Military - Check if any of the following are applicable
Vietnam Era Veteran