First Coast Technical College Application Procedures Applications will be considered only if all paperwork is completed fully and accurately and all supporting documentation is received by the FCTC Human Resource Dept. STEP 1: Application Packet Requirements: Complete the following paperwork and return to the Human Resource Dept. Letter of Intent/Cover Letter with name, current telephone number and notation of current posted position. FCTC application. Current resume. Copy of State Licensure (i.e., Nursing, Fire Fighting, EMT, Paramedic, C.N.A., or Cosmetology). Copy of Florida Educator s Certificate (if applicable) if you have applied for one please include correspondence from the FLDOE. STEP 2: Transcripts: Official transcripts can be mailed directly to the FCTC Human Resource Dept. Official transcripts mailed directly to the applicant must remain sealed and forwarded with your paperwork to FCTC. For positions requiring a HS Diploma or equivalent, please provide a copy along with your application. STEP 3: References: Reference forms are provided for your convenience. It is your responsibility to complete all necessary information and forward to your reference choices. References from relatives are unacceptable. A minimum of two (2) completed references is required. Please be sure to send reference forms to individuals who have firsthand knowledge of your job performance or teaching experience (one of which must be your last supervisor/employer). Prepared letterhead references with handwritten signatures are acceptable in place of the supplied reference forms. Recent Graduate: Send reference forms to your previous teacher and/or college administrator. You may mail, fax or e-mail your completed Application Packet to the following: FCTC Human Resource Dept. 2980 Collins Ave. St. Augustine, FL 32084 Fax: 904-547-3376 or E-mail: jobs@fctc.edu According to FL Public Records law, all e-mail communications are subject to public access. PLEASE NOTE: Applications will remain active for 90 days and may be requested to be used for future openings during that time only - all applications, resumes, transcripts, and reference forms are a permanent part of the applicant s file and cannot be returned. Rev: August 2014 com
Employment Application Full and Part Time Please type or complete in ink, printing clearly. Complete all sections even if enclosing resume. First Coast Technical College is an equal employment/affirmative action employer. Position you are applying for: Date of Application How were you referred to FCTC? Personal Data Last Name First Name Middle Initial Present Address (Street) (City ) (St ate Zip) Home Phone Email Address Have you ever been employed by FCTC? No Yes What year? ( ) Cell Phone ( ) Are you legally eligible to work in the U.S.? No Yes Type of Visa Are you related by blood or marriage to any employees of First Coast Technical College? No Yes If yes, list names, dept./area and relationship: Available for: Full-time Part-time Date available to work: Name of School or University Attended Educational and Professional Training Location Dates Attended From To Diploma, Degree or Certificate Major Minor GPA *A copy of your diploma, degree or transcript must accompany this application. Official transcripts must be received prior to first day of work. Related Educational Information Licenses, Certificates, and Registrations Issuing State Date Issued Expiration Date Lic. Number
Rev: Aug 2014 com Employment and Personal History Please list all employment (include teaching, counseling, nursing or other educational experience, if applicable), starting with the most recent. Please complete this section and attach a copy of your resume/vitae. Name of Employer Job Title or Position Held Date Started Date Left Address (City, State & Zip) Phone Supervisor's Name & Title Full Time Part Time Description of Duties Beginning Salary Ending Salary Reason For Leaving Name of Employer Job Title or Position Held Date Started Date Left Address (City, State & Zip) Phone Supervisor's Name & Title Full Time Part Time Description of Duties Beginning Salary Ending Salary Reason For Leaving Name of Employer Job Title or Position Held Date Started Date Left Address (City, State & Zip) Phone Supervisor's Name & Title Full Time Part Time Description of Duties Beginning Salary Ending Salary Reason For Leaving Professional and Civic Organizations and Activities Highest Office Held Dates of Membership Other Activities and Honors Other Qualifications (hobbies, interests and special skills)
Rev: Aug 2014 com References List three persons who are not related to you who have knowledge about your character, personality, scholarship, job performance and/or teaching ability. At least one must be a former employer. Name Position, Title, Occupation or Relationship Phone Street City State & Zip Code Instructional Applicants Only Have you ever had your contract non-renewed or resigned in lieu of termination or non-renewal from any position? No Yes Have you ever had a teaching certificate revoked or suspended? No Yes Have you ever been denied a teaching certificate anywhere? No Yes If yes to any above, please explain: Is disciplinary action currently pending anywhere against your certificate? No Yes Have you ever had your contract non-renewed or resigned in lieu of termination or non-renewal from any position? No Yes If yes to any above, please explain: PLEASE READ CAREFULLY AND SIGN BELOW I certify that all information and statements contained in this application (and accompanying documents, including Security Check and resume) are true, complete, and correct to the best of my knowledge and belief. I understand that any false statements or omissions made by me in connection with my application may be grounds for rejection of my application or for dismissal after employment. I authorize all persons listed in this application, and on any accompanying resume, to give the College any and all information concerning my previous employment and education and any pertinent information they may have, personal or otherwise, and I release all parties, such persons and the College from liability for any damage that may result from furnishing the same to the College. I hereby authorize FCTC to investigate, through whatever means deemed appropriate by the College, any information included in this application and all facts resulting from the investigation unless otherwise noted. The College is also authorized to use any information obtained from its investigations to determine my suitability for employment. I release the College from any liability in connection with such investigation. I also agree to execute as a condition of employment or a condition of continued employment any additional written authorizations necessary for the College to obtain access to and copies of records pertaining to this information. I understand that neither filing this application nor being granted an interview will create an employment contract between me and FCTC; I understand that submission of this application does not obligate FCTC in any way. If employed, I agree to abide by the policies, procedures, rules, and regulations of FCTC. I acknowledge the College's prerogative of revising, at any time, its policies, procedures, rules, and regulations and I agree to abide and be governed by such revisions. I understand FCTC prohibits the unlawful possession, use, or distribution of illicit drugs and/or alcohol by employees on its property or as part of any its activities. FCTC is a drug/substance free workplace. There are drug and alcohol screening / testing guidelines in place. Any employee who violates these standards of conduct for illicit drugs or the unlawful possession or use of alcohol is subject to the screening/testing policy and/or termination. This application and supporting documents will become the property of FCTC. If offered employment I must provide evidence of my eligibility to work in the United States. Signature of Applicant Date Please mail, fax or e-mail your completed Application Packet to the following: FCTC Human Resource Dept. 2980 Collins Ave., St. Augustine, FL 32084 Fax: 904-547-3376 or E-mail: jobs@fctc.edu First Coast Technical College is an equal opportunity institution in education and employment. It is the policy of FCTC to provide equal opportunities without regard to age, race, color, religion, national origin, gender, disability, genetic information or veteran status. Rev: Aug 2014 com
IDENTIFICATION OF PROTECTED GROUPS - CONFIDENTIAL INFORMATION Name: Date: FCTC is an equal employment opportunity employer. Certain laws and regulations regarding equal employment opportunity require us to compile annual statistical reports on applicants for employment. In order to comply with these laws and regulations, we are requesting your cooperation in completing this Voluntary Applicant Self-Identification Form. The information will be kept strictly confidential. Completing this form is strictly voluntary and will have no effect upon your employment. The statistics gathered from this form help us assess our outreach and recruitment efforts. Position Applying For: Please one of the following: Male Female Veteran Status: (check any that are applicable) None Vietnam Veteran Only Other Protected Veteran Both Vietnam & Other Eligible Veteran Are you claiming Veteran s Preference? Yes No If Yes, preference will be given to eligible veterans & spouses when a DD214 is provided during the application process. Are you Hispanic or Latino? Yes No Select one or more of the following races: American Indian/ Alaskan Native A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam. White/Caucasian - A person having origins in any of the original peoples of Europe, North Africa, or the Middle East. Native Hawaiian or Other Pacific Islander A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands. Black/African American - A person having origins in any of the Black racial groups of Africa. Two or more races All persons who identify with more than one of the above races. Rev: Aug 2014 com
Security Check (This section must be completed) Name: Last 4 Digits of Social Security Number: Driver s License or ID #: State: Expires: Commercial Driver s License # (CDL): State: Expires: Applicants At the time of employment, local, state and federal law enforcement agencies will research your fingerprints. Sealed or expunged records must be revealed to the First Coast Technical College/St. Johns County School District pursuant to F.S. ' 943.085. Pursuant to F.S. '231.02 (2) (a), your employment with the FCTC/SJCSD is temporary and probationary pending successful processing of your fingerprints. The following questions must be answered truthfully. Your omission of any criminal history may be grounds for termination. Pursuant to Florida Statues ' 943.058, Criminal History Records or Sealing, persons to be employed in a position having direct contact with children must answer question 9. To omit response or to be untruthful, regardless of any previous information received from your attorney or the Court, will be considered falsification of your application and will result in termination. If you wish to seek counsel prior to completing this section, please do so. 1. Has your driver s license ever been revoked or suspended? No Yes *Include penalties as a result of DUI/DWI charges. 2. Have you had any traffic violations during the past three (3) years? No Yes If you answered yes to either question list details below, please include with city, state, location and date of arrest, charge and disposition. 3. Are criminal charges other than minor traffic violations currently pending against you? No Yes 4. Have you EVER pled guilty to a criminal offense? No Yes 5. Have you ever been convicted or fined in a criminal proceeding? No Yes 6. Have you ever been placed on probation in a criminal proceeding? No Yes *Include participation in a pre trial intervention program. 7. Have you ever pled a non contest in a criminal proceeding? No Yes 8. Have you ever had adjudication withheld in a criminal proceeding? No Yes 9. Have you ever had charges expunged (charges erased) from an arrest or from a pardon of conviction? No Yes (Under Florida Statutes ' 943.058, expunged or sealed records are available to district school boards) 10. Have you ever failed to appear in court or forfeited bond in a criminal proceeding? No Yes If you responded YES to any of the above questions, please include with city, state, location, date of arrest, charge and disposition: Signature of Applicant Date Rev: Aug 2014 com
Reference Form APPLICANT PLEASE COMPLETE THE PORTION BELOW: Name of applicant Position applied for The applicant named above has applied for a position with the First Coast Technical College and has given your name as a reference. Your completion of this form will be most helpful in our assessment of the applicant's qualifications. Please return this form directly to our Human Resources office at the address below. Signature of applicant 5 Clearly outstanding 4 Exceeds expectations 3 Satisfactory 2 Below Expectations 1 Unsatisfactory PERSONAL QUALITIES AND CHARACTERISTICS 5 4 3 2 1 Unknown General appearance Attendance/Punctuality Communication skills Initiative Professional judgment Response to supervision Enthusiasm Commitment Emotional poise Ability to work with others Overall Job Performance TEACHING/INSTRUCTIONAL ONLY (IF Applicable) 5 4 3 2 1 Unknown Knowledge of subject matter Use of effective methods and techniques Lesson planning and preparation Enthusiasm for teaching Classroom management (including discipline) Interest in professional growth Sensitivity to individual student needs Ability to communicate with community and/or parents How long have you know this applicant? What was your official relationship with the applicant? If co worker or supervisor please state applicants job title/position: Would you employ/re employ this person? Additional comments (use back if needed): Signature Address Phone number Position City/State/ZIP Code Date Please return completed form to: Human Resources, 2980 Collins Ave, St. Augustine, FL or Fax: 904 547 3376 Rev: Aug 2014 com
Reference Form APPLICANT PLEASE COMPLETE THE PORTION BELOW: Name of applicant Position applied for The applicant named above has applied for a position with the First Coast Technical College and has given your name as a reference. Your completion of this form will be most helpful in our assessment of the applicant's qualifications. Please return this form directly to our Human Resources office at the address below. Signature of applicant 5 Clearly outstanding 4 Exceeds expectations 3 Satisfactory 2 Below Expectations 1 Unsatisfactory PERSONAL QUALITIES AND CHARACTERISTICS 5 4 3 2 1 Unknown General appearance Attendance/Punctuality Communication skills Initiative Professional judgment Response to supervision Enthusiasm Commitment Emotional poise Ability to work with others Overall Job Performance TEACHING/INSTRUCTIONAL ONLY (IF Applicable) 5 4 3 2 1 Unknown Knowledge of subject matter Use of effective methods and techniques Lesson planning and preparation Enthusiasm for teaching Classroom management (including discipline) Interest in professional growth Sensitivity to individual student needs Ability to communicate with community and/or parents How long have you know this applicant? What was your official relationship with the applicant? If co worker or supervisor please state applicants job title/position: Would you employ/re employ this person? Additional comments (use back if needed): Signature Address Phone number Position City/State/ZIP Code Date Please return completed form to: Human Resources, 2980 Collins Ave, St. Augustine, FL or Fax: 904 547 3376 Rev: Aug 2014 com