Bay College Application for Employment-Required for All Positions

Application for Employment
AN EQUAL OPPORTUNITY EMPLOYER

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, political affiliation, age, height, weight, disability, veteran or marital status, or any legally protected classification.
This application is only valid until the position for which you are applying is filled. You will have to reapply for any future openings. (PLEASE PRINT)

Position Applying for: Date of Application:

Where did you hear about this position? Walk-In___ Friend___

Advertisement (Where?) ____________________________

Employment Agency___ Relative___ Other ____________________________________________________

Last Name	First Name		Middle Name
Address			City/State/Zip
Telephone Number	Email Address
			Yes	No
Are you 18 years of age or older?
If you are less than 18 years old, can you provide required proof of your eligibility to work?
Are you lawfully entitled to be employed in the United States?
Have you ever been employed at Bay College before?
Are you currently employed?
May we contact your present employer?
Can you travel if a job requires it?
Have you ever been convicted of a felony? (Conviction will not necessarily disqualify an applicant from employment.) If yes, please explain:
When can you be available for work?
Can you work: (Check all that apply to you)	Full Time	Part Time	Shift Work	Temporary

Education

	Name & Address of School	Course of Study	Number of Years Completed	Diploma/Degree
High School/GED
Undergraduate College
Graduate Professional
Other (Specify)

Employment Experience - Please complete this section even if you are including a resume`

Employer:	Work Performed:
Address:
Telephone Number(s):
Dates Employed: From: To:	Job Title: Supervisor:
Reason for Leaving: Final Salary (Optional):$

Employer:	Work Performed:
Address:
Telephone Number(s):
Dates Employed: From: To:	Job Title: Supervisor:
Reason for Leaving: Final Salary (Optional):$

Employer:	Work Performed:
Address:
Telephone Number(s):
Dates Employed: From: To:	Job Title: Supervisor:
Reason for Leaving: Final Salary (Optional):$

Employer:	Work Performed:
Address:
Telephone Number(s):
Dates Employed: From: To:	Job Title: Supervisor:
Reason for Leaving: Final Salary (Optional):$

If you need additional space for your Employment Experience, please continue on a separate sheet of paper.

Additional Information

Please summarize special job-related skills and qualifications acquired from employment or other experience.



References

Name	Phone Number
Address

Name	Phone Number
Address

Name	Phone Number
Address

It is the policy of the Bay de Noc Community College Board of Trustees to maintain a drug-free workplace in compliance with the requirements of the Drug-Free Work Place Act of 1988, 34 CFR Part 85, Subpart F. Bay de Noc Community College reserves the right to request drug testing in accordance with the College Drug-Free Work Place Policy.

Applicant's Statement - Required for Application
I certify that the answers and information given herein and during employment interviews, and information within a cover letter, resume and other materials, are true, complete and accurate. I authorize investigation of all statements contained in this application and accompanying materials for employment as may be necessary in arriving at an employment decision. I hereby authorize a criminal background check and the investigation of my past and present work, education, character, and police records, to determine any and all information, excluding medical information, deemed relevant by Bay de Noc Community College and its investigating employees or agents to assess my character, reputation, certification, licensure, academic and/or work record and experience.

In the event of employment, I understand that false or misleading information given in this application and accompanying materials or interview(s) may result in discharge. I understand also that I am required to abide by all rules and regulations of Bay de Noc Community College.

An offer of employment is made subject to satisfactory proof that I am legally authorized to work in the United States. I understand that if I do not supply satisfactory proof I will not be eligible to work at Bay de Noc Community College.

I hereby understand and acknowledge that, unless otherwise defined by applicable law or union contract, any employment relationship with Bay de Noc Community College is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge the employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by contract unless such change is specifically acknowledged in writing by an authorized executive of Bay de Noc Community College.

I understand that, where Board approval is required, I am not employed by Bay de Noc Community College until approved by the Board of Trustees. For those positions that do not require Board approval, I understand that I am not employed by Bay de Noc Community College until informed in writing by the Director of Human Resources.
_____________________________________ _____________________________
Signature of Applicant Date Signed

Authorization to Release Information - Required for Application

I have been asked to supply information for assessing my background and qualifications. To facilitate this process, I hereby authorize a criminal background check and the investigation of my past and present work, education, character, and police records, to determine any and all information, excluding medical information, deemed relevant by Bay de Noc Community College and its investigating employees or agents to assess my character, reputation, certification, licensure, academic and/or work record and experience.

I hereby authorize you to provide any and all information, of record or not, and exonerate and release Bay de Noc Community College and all persons, agencies and firms from any damages that may result from providing such information.

I waive written notice of the disclosure of any disciplinary reports, reprimands and/or personnel actions from my current and former employer(s). This waiver shall be inclusive of a waiver of rights under Section 6(3) of the Bullard-Palwecki Employee Right to Know Act.

Date/Signature of Applicant:_____________________________________________________________

Date/Signature of Witness:______________________________________________________________

(For office use only:)
To: _________________________________________________________________
Address: _________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Revised 5/2004

Affirmative Action Data Record

During employment, employees are treated without regard to race, color, religion, creed, gender, national origin, political affiliation, age, height, weight, disability, veteran or marital status, or any other legally protected classification. As an employer with an Affirmative Action Program, we comply with government regulations, including Affirmative Action responsibilities where they apply. The purpose for this Data Record is to comply with government record keeping, reporting and other legal requirements. Periodic reports are made to the government on the following information. The completion of this Data Record is optional. If you choose to volunteer the requested information, please note that all Data Records are kept in a Confidential File and are not part of your Application for Employment or personnel file. Please note: Your cooperation in completing the Affirmative Action Data Record is voluntary. Inclusion or exclusion of any data will not affect any employment decision.

Last Name	First Name	Middle Name
Address		City/State/Zip
Telephone Number		Birthdate

REFERRAL SOURCE (Where did you hear about this job opening?):
Walk-in ___ Friend ___ Advertisement (Where?) _________________________________
Employment Agency ___ Relative ___ Other _________________________________

Current Job: ____________________________________________________________

Gender: Male___ Female___

Check One of the following (Ethnic Origin): White ___ American Indian/Alaskan Native ___ Hispanic ___
Black ___ Asian/Pacific Islander ___ Other _________________________

Check any of the following which are applicable: Vietnam Era Veteran ___ Disabled Veteran ___ Disabled Individual ___


Submit Application materials to:
Mr. Thomas J. Griggs, Director
Human Resources Bay de Noc Community College 2001 North Lincoln Road Escanaba MI 49829
ON-Line Applications may be submitted to: employapp@baycollege.edu Phone: (1-800-221-2001 ext. 1159) ~ Fax: (906) 789-6925

(Note: For most positions at Bay de Noc Community College, you will be required to submit a cover letter, your resume', your completed Application for Employment, and copies of your undergraduate and graduate transcripts in order for your file to be considered complete.)

We do not accept unsolicited applications for employment when there are no vacant positions. For Adjunct Instructor positions, we accept applications as all times.