Employment Application, Part-Time (Adjunct) Faculty

Eastern Iowa Community College District Clinton Community College - Muscatine Community College - Scott Community College 306 West River Drive, Davenport, Iowa 52801-1221, (563)336-3342 Employment Application, Part-Time (Adjunct) Faculty
*Required fields.
Date:
Name
Preferred Title: (Not Required)	Other:
Last:*
First:*
Middle:*

Address
Address:*
City:*	State:* Zip:*

Phone (please include your area code)
Home:*
Cell:
Work:

E-mail Address:*

Position Desired
Site:* (check all that apply)	Clinton Community College Muscatine Community College Scott Community College Online

Teaching Area
Arts & Sciences (College Transfer - Must have MA or MS degree in area teaching or a MZ?MS degree and 18 gradute hours of credit in the area you wish to teach)
Area(s) you want to teach: (Examples of teaching areas: Business, Biology, English, etc.)


Applied Technologies (Career/Technical Education degrees, Associates of Applied Science programs 2 in length, but also some Certificate and Diploma Programs) Relevant Business/Industry experience years is critical. Some programs require a Graduate degree, some, a four-year degree, while other areas require Journeyman/apprenticeship or equivalent certification. Teaching requirements vary from department to department. Examples of teaching areas : Allied Heath Services, Business, Child Development & Sign Language Interpreter Training, Culinary Arts and Hospitality Services, Industrial & Design & Environmental, Health, Safety & Environmental, Manufacturing, Microcomputer Information, Nursing, and Transportation)
Area(s) you want to teach:


Education/Training
High School:*
Year Graduated:*

College/University, Technical School:*
Degree/Certification:*
Major:*
Year Graduated:*

College/University, Technical School:
Degree/Certification:
Major:
Year Graduated:

College/University, Technical School:
Degree/Certification:
Major:
Year Graduated:

Certifications/Licensures
List any special certifications by professional governing bodies, or governmental agencies that are related to your application area.


Work Experience and/or Relevant Volunteer Experience
Date:*
Description of Experience:*
Employer: (if applicable)

Date:
Description of Experience:
Employer: (if applicable)

Teaching and/or Training Experience
Date:	Number of Years:
Institution:
Courses Taught:

Date:	Number of Years:
Institution:
Courses Taught:

Work Availablity
Days of Week:*
Monday Tuesday Wednesday Thursday Friday Saturday

Time of Day:*
Morning Afternoon Evening

Are you willing to teach On-line classes via the Internet:*
Yes No

Fluency/Special Skills
Language Fluency:*
Are you fluent in English:	Yes No
Are you Fluent in any other language(s):

Special Skills you possess related to your application:


Note You may attach a cover letter to address strengths or preferences that were not part of the application. You may also attach a resume. If you are invited for an interview, please bring an unofficial copy of your transcripts to that meeting. If you are hired, official transcripts must be on file in the applicable Division Office. You will need to send an e-mail attachment for your 'Cover Letter' and 'Resume' to, rshoesmith@eicc.edu.

References Please list 3 references and contact information
Name:*
Position:
Name of Organization:
Phone Number:
Address:

Name:*
Position:
Name of Organization:
Phone Number:
Address:

Name:*
Position:
Name of Organization:
Phone Number:
Address:

The Eastern Iowa Community College District endorses the principle of equal educational opportunities for all people regardless of race, color, creed, marital status, national origin, sex, sexual orientation, religion, ancestry, age, or non-job related handicap or disability in the educational programs or activities it operates. Persons having inquiries concerning the district's accommodation for or compliance with Title VI, Title IX, Section 504, the Americans with Disabilities Act and the Age Discrimination Act may contact: Affirmative Action Officer, 306 W. River Drive, Davenport, IA 52801-1221 or call *(563) 336-3300.
NOTE: Submitting this application os considered the same as a written signature..
I certify that the information given herein is true and complete to the best of my knowledge.
I Agree*

PLEASE NOTE:
Be sure to print out the next screen to have a copy of this form for your records.

Eastern Iowa Community College District

Employment Application, Part-Time (Adjunct) Faculty