Eastern Iowa Community College District  Clinton Community College   Muscatine Community College   Scott Community College 306 West River Drive, Davenport, Iowa 52801-1211, (563) 336-3342     Employment Application, Part-Time (Adjunct) Faculty

Fields with a  *  are required.       Date:      * Name - Last:    First:    Middle:      * Address:      * City:      * State:    * Zip Code:                                        (please include your area code)   Phone -   * Home:       Cell:       Work:      * E-mail Address:                              If you do not have an e-mail address please contact Reg Shoesmith at                                      (563) 441-4177 for information on how to complete this electronic application.     Position Desired      *  Site:  Clinton Community College     Muscatine Community College     Scott Community College           Teaching Area:   Arts & Sciences  (College Transfer-Must have MA or MS degree in area teaching or a MA/MS degree and 18 graduate 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  (this may be detailed on your resume)      * 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 Availability      * Days of Week:       Mon.     Tues.     Wed.     Thur.     Fri.     Sat.    * 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?                  Special Skills you possess related to your application:             Note: (1)  You may attach a cover letter to address strengths or preferences that were not part of the        application. (2)  You may also attach a resume. (3)  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:       Telephone #:       Address:       * Name:       Position:       Name of Organization:       Telephone #:       Address:       * Name:       Position:       Name of Organization:       Telephone #:       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 is 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:      After you have finished filling out this application, please be sure to print out a copy for your records before hitting the submit button.     Fields with a  *  are required.