Application For Employment


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You will receive a confirmation email once you've submitted this form, letting you know your application has been received. This application becomes void after 365 days if not renewed.

* denotes required fields

Personal Information


Employment Information

* Part-Time: List total hours worked per week. If hired your salary calculation is based on the information provided below.

Please start with your most current position as position #1.

Your Position #1

Are you currently employed at this position?


Please indicate if the position was full or part time? (Include hours if part time)


May we contact this position's listed supervisor?

*Reason for leaving this position:


Your Position #2

Are you currently employed at this position?


Please indicate if the position was full or part time? (Include hours if part time)


May we contact this position's listed supervisor?

*Reason for leaving this position:


Your Position #3

Are you currently employed at this position?


Please indicate if the position was full or part time? (Include hours if part time)


May we contact this position's listed supervisor?

*Reason for leaving this position:


Your Position #4

Are you currently employed at this position?


Please indicate if the position was full or part time? (Include hours if part time)


May we contact this position's listed supervisor?

*Reason for leaving this position:


Your Position #5

Are you currently employed at this position?


Please indicate if the position was full or part time? (Include hours if part time)


May we contact this position's listed supervisor?

*Reason for leaving this position:


Your Position #6

Are you currently employed at this position?


Please indicate if the position was full or part time? (Include hours if part time)


May we contact this position's listed supervisor?

*Reason for leaving this position:


Your Position #7

Are you currently employed at this position?


Please indicate if the position was full or part time? (Include hours if part time)


May we contact this position's listed supervisor?

*Reason for leaving this position:



Formal Education

List beginning with most recent.

*Institution *Location *Diploma/Degree *Dates of Attendance
Start:
End:
Major Minor
*Institution *Location *Diploma/Degree *Dates of Attendance
Start:
End:
Major Minor
*Institution *Location *Diploma/Degree *Dates of Attendance
Start:
End:
Major Minor


Special Training not listed above

Institution Course or Program Credit Earned Dates of Attendance
Start:
End:
Start:
End:

Professional Associations


Second Language Proficiency

Proficiency Level Definitions

  1. Beginner Level - A student of the language, cannot be depended on to apply this language reliably in a real world situation.

  2. Conversational Level - Basic speaking and comprehension skills in the language, able to express yourself in the language and can exchange basic ideas with someone who only speaks the language.

  3. Fluent Level - Fully versed in the language, speaking, reading, and writing it as well as a native speaker.

Language Speaking Proficiency Reading Proficiency Writing Proficiency

Work Status

*1. Have you ever been involuntarily terminated from any previous position?
No
Yes

*2. Are you authorized to work in the United States?
No
Yes **(Proof of citizenship or immigration status will be required upon employment.)

*3. Are you a veteran?
No
Yes


Criminal Background

*1. Have you ever been convicted of a crime other than a simple misdemeanor offense relating to motor vehicles and laws of the road under chapter 321 or equivalent provisions, in this state or any other state?
No
Yes


*2. Do you have a record of founded child or dependent adult abuse?
No
Yes

(Conviction will not necessarily disqualify an applicant from employment.)
(IVCCD Board Policy 403 requires IVCCD to perform post-offer, pre-employment  background checks, which may include but are not limited to criminal background checks as authorized by Section 692.2 of the Iowa Code, child abuse and/or dependent adult abuse record checks and/or sexual abuse registry checks.)



Optionally you can attach your resume here:



Optionally you can attach a cover letter here:




Where did you learn about this position?:*




*1. Have you ever been employed with Iowa Valley Community College District?
No
Yes


*2. Do you have a family member who is currently employed with Iowa Valley Community College District?
No
Yes

Please read and sign below:

Iowa Valley Community College District maintains an active application file for twelve months.  If you wish to activate your application for any position during that time, please notify the Human Resources Office. 

IVCCD is an equal opportunity employer.  Applicants for all positions are considered without regard to race, religion, color, marital status, sex, national origin, age, disability, sexual orientation, or gender identity, or any other legally protected status.

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed;  false or misleading statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and authorize the  persons and entities listed above to give you any and all information concerning previous employment and any pertinent information they may have, personal or otherwise, and I hereby release all parties from liability for any damage that may result from furnishing such information to you.


Please type your signature and today's date





Electronic submission of this application confirms the typed signature.