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Employment Application

To be considered for employment, you are required to complete an application form. The offer of employment is contingent upon the ability to provide documentation which demonstrates employment eligibility required by the Immigration Reform and Control Act of 1986. All new employees will be required to complete an “Employment Eligibility Verification” ( Form I-9 ) and produce requested documentation after employment. *Federal law requires to Butler Community College to hire only United State citizens and aliens authorized to work in the United States.

Please answer completely and sign the application form.

Select a committee(s) that will be able to view this application.
Personal Information
Full Name
Address
Telephone Number
List other names under which employment or academic records have been filed.
Position Information
Position(s) for which you are applying
Education
Name of colleges, universities, or other post-secondary institutions attended

List most recent education first.

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Teaching Experience (For academic professionals only)
NeitherFull-timePart-time
Community College
4-year college or University
High School or elementary setting
Other education setting
If applying for a teaching position, you must include transcripts/credentials.
Other Pertinent Information
“A conviction record will not necessarily be a bar to employment. Factors such as length on incarceration, the seriousness and nature of the offense, and the applicant’s rehabilitation will be considered in the hiring decision.”
Skills and Certifications
Second Language Ability
References
Current Supervisor
Three References
(Do not include relatives, personal friends, or immediate supervisors already listed in the employment section)
Employment History

Provide complete information for all current and past employment. Begin with present or most recent employment.
Attach additional employment history if necessary.

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Address and Phone

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Address and Phone

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Address and Phone

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Address and Phone

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Address and Phone

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Address and Phone

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Address and Phone

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Address and Phone

Please explain breaks or periods of unemployment in your employment history
Upload Files and Add URLs
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.
Upload a resume, published work, or other documents.

Add a URL to personal website or portfolio.

Add a URL to personal website or portfolio.

Add a URL to personal website or portfolio.

Application Certification and Authorization Release

I hereby authorize investigation of all statements contained in this application. I certify by the signature below that all statements are true and correct, and that misrepresentation or omission of facts called for in this form is sufficient cause for termination of employment without notice. If employed, I agree to comply with all policies, procedures, and regulations of Butler County Community College and applicable local, state, and federal laws currently existing or that may exist in the future.

A resume, or other appropriate materials may be included with application but may not be submitted instead of the application. If employed, the college may require certified transcripts for any college-level education listed on this application.

Information provided on this application will become part of your permanent personal record if you are employed at Butler. Materials submitted for consideration as part of the application for employment are not returnable.

Butler Community College is committed to nondiscrimination on the basis of gender, race, color, national origin, age, religion, mental or physical disability, marital or parental status, or status as a veteran. Employment decisions are based strictly on job related qualifications and an individual's ability to perform the job.

To report discrimination under Title IX (sex) contact the Title IX Coordinator at 316-323-6942. To report discrimination under Section 504 (handicap) contact the Coordinator of Special Needs/ADA Compliance Officer at 316-322-3321 (local) or 316-733-3321 (Wichita Metro). You may also contact the Director of Human Resources at 316-322-3152 (local) or 316-733-3152 (Wichita Metro). These offices are located at 901 S. Haverhill Rd., El Dorado, KS, 67042.


BUTLER COMMUNITY COLLEGE IS AN
EQUAL OPPORTUNITY EMPLOYER