Northern Oklahoma College Application for Employment Return to: Human Resources Office P.O. Box 310, Tonkawa, OK 74653 Position applying for: Tonkawa Enid Stillwater Other Full-Time Part-Time Temporary Personal Information Last Name First Name Middle Address City, State, Zip Contact Phone Email address Are you willing to take a drug test? Yes No Are you legally authorized to work in the United States? Yes No Documentation of your identity and employment eligibility must be provided upon hire as required by the Immigration Reform and Control Act of 1986. Do you have any relatives employed at NOC? Yes No (If yes, please list below) (Name, Relationship, and Department) Education High School Diploma/G.E.D: Yes No If no, indicate highest grade completed: Names of colleges or universities attended (list most recent education first) Dates Attended Major Minor Degree or Certificates Earned Where did you hear of this opening? Newspaper Website Other: list Skills and Certifications List all valid professional licenses you hold; include the certification number and the date of expiration. Indicate other employment skills, special training or related courses that you would like considered as part of your application. Describe significant contributions and achievements, including publications or awards, in professional and/or civic activities that you would like considered as part of your application. Please click on the link to view Northern Oklahoma College ’s Annual Security and Fire Reports . Employment Experience Please list all prior employment beginning with current or most recent employment first. May we contact your present employer? Yes No Supervisor: Employer Immediate Supervisor Title Employer's Address City, State, Zip Phone and/or email Position Held Date of Employment Reason for Leaving Employer Immediate Supervisor Title Employer's Address City, State, Zip Phone and/or email Position Held Date of Employment Reason for Leaving Employer Immediate Supervisor Title Employer’s Address City, State, Zip Phone and/or email Position Held Date of Employment Reason for Leaving Professional References First and Last Name Email address Address City, State, Zip Phone number First and Last Name Email address Address City, State, Zip Phone number First and Last Name Email address Address City, State, Zip Phone number First and Last Name Email address Address City, State, Zip Phone number First and Last Name Email address Address City, State, Zip Phone number I hereby understand that all information provided on this application is true and accurate, and understand that a background search will be processed for every NOC employee prior to the finalization of their employment. Signature of Applicant Date Notice of Nondiscrimination Northern Oklahoma College does not discriminate on the basis of race, color, national origin, sex/gender, age or disability in admission to its programs, services or activities, in access to them, in treatment of individuals or in any aspect of their operations. Northern Oklahoma College also does not discriminate in its hiring or employment practices. This notice is provided as required by Title VI of the Civil Rights Act of 1964, Section 594 of the Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975 and the Americans with Disabilities Act of 1990, Questions, complaints or requests for additional information regarding these laws may be forwarded to the designated compliance coordinator, Jason Johnson, Vice President for Student Affairs, 1220 East Grand Avenue, PO Box 310, Tonkawa, OK 74653- 0310; telephone 580-628-6240 8 a.m. to 5 p.m. Monday through Friday.
