A P P L I C A T I O N F O R E M P L O Y M E N T
CATAWBA VALLEY
COMMUNITY COLLEGE
2550 Hwy. 70 SE • Hickory, NC 28602-6999 • Telephone: 828.327.7000 Ext. 4103/4277 • Website:
http://www.cvcc.edu
CVCC IS AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION INSTITUTION
Click here to download a printable version of this application
Last Name:
First Name:
Middle:
Date:
(Example: 04/05/2002)
Street Address:
Home Telephone:
-
-
Cell Phone:
-
-
City:
State:
Zip:
Business Telephone:
-
-
State Names of Relatives, if any, employed by CVCC:
Email:
In case of Emergency, notify:
Telephone:
-
-
Pay Expected:
Have there been or are there any circumstances which have or may interfere with your work performance and/or regular attendance?:
Yes
No
If "yes" please describe in area below:
(Performance interference)
Have you ever been convicted for anything other than minor traffic violation?
Yes
No
If "yes" please describe:
(Convicted)
Are you a veteran of military service?
Yes
No
If "yes" give dates, branch, & types of duties performed:
(Verteran of Military Service)
If required, I certify that I am in compliance with 50 United States (Military Selective Service Act) in that I have subjected myself to Selective Service Registration:
Yes
No
Not Applicable
Position(s) Applied for:
Please check the types of work you will accept:
Full-time
Part-time
When will you be available for employment?
School
Name & Location
Course of Study / Major
Dates Attended
Did You Graduate?
Degree / Diploma
Graduate
From:
To:
Yes:
No:
College
From:
To:
Yes:
No:
Business / Trade
/Technical
From:
To:
Yes:
No:
High School
From:
To:
Yes:
No: