Part-time Faculty: Sociology (Perry High School)

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EMPLOYMENT HISTORY 3.a. Employer Name, Address and Phone *

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REFERENCE 1: Provide PROFESSIONAL/WORK references from positions held within the last ten years. *

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REFERENCE 3: Provide PROFESSIONAL/WORK references from positions held within the last ten years. *

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I certify that the answers I have made to all of the questions in this application are true and complete to the best of my knowledge. I understand that any material omission, misrepresentation or falsification of this information is sufficient cause for rejection of my application or termination of my employment.

I understand that any offer of employment is conditional upon proof of legal authorization to work in the United States as required by the Immigration Reform and Control Act.

I hereby authorize representatives of Lakeland Community College to obtain background information about me including but not limited to verification of education, investigation of present and past employment, and review of criminal convictions. I also give consent for representatives of Lakeland Community College to obtain a Driver’s Abstract Report from a state in which I have held a standard or commercial driver’s license in the past five years if driving is an essential function of the position. I understand that I may be considered ineligible for employment if my driving record does not meet the standards of Lakeland Community College and/or its insurer. I release Lakeland Community College and its representatives from liability for seeking such information and all sources for furnishing such information.

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Lakeland Community College is an equal access and equal opportunity employer. We have a strong commitment to the principle of diversity and, in that spirit, seek a broad spectrum of candidates including women, minorities, people with disabilities and people over 40. Under-represented groups are encouraged to apply. If your disability requires special accommodations to participate in the application/interview process, contact the Human Resources Office at 440-525-7575.

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