Fillable Printable Employment Application - Delaware Technical Community
Fillable Printable Employment Application - Delaware Technical Community
Employment Application - Delaware Technical Community
OFFICE USE ONLY
Name
Position applied for Date Rec'd
Jack F. Owens Campus
Human Resources Office
21179 College Drive
Georgetown, DE 19947
(302) 259-6160
(302) 259-6767 (Fax)
Office of the President
Human Resources Office
PO Box 897
Dover, DE 19903
(302) 857-1661
(302) 857-1645 (Fax)
Terry Campus
Human Resources Office
100 Campus Drive
Dover, DE 19904
(302) 857-1290
(302) 857-1297 (Fax)
Wilmington Location
Human Resources Office
333 Shipley Street
Wilmington, DE 19801
(302) 573-5469
(302) 577-3827 (Fax)
Stanton Location
Human Resources Office
400 Stanton-Christiana Road
Newark, DE 19713
(302) 454-3916
(302) 453-3028 (Fax)
Delaware Technical Community College
Application for Employment
ATTENTION: The "Submit Form" button is not working; do not press "Submit Form". Please save and attach
application to an e-mail, fax it, mail it, or deliver it in person.
The College does not accept unsolicited résumés or employment applications. We will only accept a résumé and/or
cover letter in conjunction with a completed application for a current posted vacancy. In order to be considered for a
position, the completed application form must be received in a Delaware Technical Community College Human
Resources Office by the due date and time listed on the Staff Vacancy Announcement.
Applications are accepted via mail, fax, in person, or by e-mail. Applicants who choose to apply by fax or e-mail
must do so recognizing that Delaware Tech cannot ensure the privacy of an application.
Notice of Availability of Annual Security Report
Delaware Technical Community College maintains an annual security report as required by the Clery Act. The
College's annual Clery Act report contains information on campus security and personal safety, including crime
prevention, the law enforcement authority of College public safety officers, crime reporting policies, certain specific
College policies, and other important matters about security on campus. The report also contains statistics for the
three previous calendar years on crimes that were reported to have occurred on campus, in certain off-campus
buildings or property owned or controlled by the College, and on public property within or immediately adjacent to
and accessible from the campus.
The College's annual Clery Act report is available on the Delaware Tech Web site at
https://www.dtcc.edu/about/public-safety/your-right-know. A printed report may also be obtained free of charge
from the Office of Public Safety at each campus upon your request.
An Equal Opportunity Employer
It is the policy of the College that no person shall, on the basis of race, color, creed, sex, national origin, age disability,
sexual orientation (defined exclusively as heterosexuality, homosexuality, or bisexuality), or genetic information be
subjected to any discrimination prohibited by the Civil Rights Act of 1964, as amended; the Age Discrimination in
Employment Act, as amended; Americans with Disabilities Act, as amended; Section 504 of the Rehabilitation Act of 1973;
Title IX of the Educational Amendments of 1972; the Genetic Information Nondiscrimination Act of 2008 and other
applicable laws, regulations and Executive Orders. This policy applies to recruitment, employment and subsequent
placement, training, promotion, compensation, continuation, probation, discharge and other terms and conditions of
employment over which the College has jurisdiction as well as to all educational programs and activities.
The College has designated a Civil Rights Coordinator, who serves as the College’s Title IX Coordinator and the College’s
ADA/Section 504 Coordinator, to carry out its commitment to equal opportunity and nondiscrimination. Inquiries or
complaints by students or employees regarding the College’s nondiscrimination policies may be addressed to:
Dr. Valencia "Lynn" Beaty
Assistant Vice President for Civil Rights
Office of the President
P.O. Box 897
Dover, DE 19903
(302) 857-1903
ALL OF THE ITEMS MUST BE COMPLETED IN ORDER FOR THIS APPLICATION TO BE CONSIDERED VALID.
Attaching a résumé does not preclude you from completing all sections of this application in full.
(Please type or clearly print your responses.)
Personal Data
(Middle)
(First)
(State)
(Zip)
(City)
(Street)
Address (Number)
Work Telephone NumberHome Telephone Number
Have you been employed with us before?
Position Title applied for
If yes, give date:
May we contact your present employer?Are you currently employed?
Does your VISA or Immigration Status
allow you to be lawfully employed in this country?
Proof of citizenship or immigration status will be required upon employment.
On what date are you available
for work?
If you are under 18 years of age, can you provide
required proof of your eligibility to work?
Name
(Last)
E-mail Address
Cell Phone Number
Date of Application
Full-Time Part-Time
(Please type or print using ink)
Position Status
No Yes
No Yes No Yes
No Yes
N/A
No Yes
N/A
Are you retired from the State
of Delaware?
No Yes
Where did you hear about this job?
Delaware Tech Web site
Newspaper Please Specify Other Please Specify
Are you related to any employee who works at the College?
Yes No
If so, please list employee name and campus.
Veteran Status:
I am not a veteran
Veteran
Disabled Veteran
Spouse of a member of the armed forces who is listed in one or more of the
following categories for a total of more than 90 days:
1. Missing in action
2. Captured in line of duty by foreign government or power
3. Forcibly detained or interned in line of duty by a foreign government or power
Spouse of a veteran who has a service connected disability
Unremarried widow or widower of a deceased veteran
I choose not to disclose
Education (Official transcripts of all relevant education are required before any final offer of employment can be made)
Circle or (click on) the highest grade completed in each school category.
Technical, Business School
or College
Graduate SchoolSecondary School
Dates Attended
Type of
Did you
Subject or
(Month / Year)
Diploma/
Graduate?
Specialization
Yes or No
From To
Degree Rec'd
High School
College
or
University
Other
Name of School City and State
7 8 9 10 11 12 1 2 3 40
1 2 30
(If more space is required, use Additional Information page (included)
Employment (List most recent first)
Work Performed
Telephone Number(s)
Dates Employed
Employer
From To
(Month/Year)
Position HeldAddress
Supervisor's Name
Hourly/Annual Salary
Reason for Leaving
Starting Final
Full-Time
Part-Time
(City) (State) (Zip)
(Street)
Work Performed
Telephone Number(s)
Dates Employed
Employer
From To
(Month/Year)
Position HeldAddress
Supervisor's Name
Hourly/Annual Salary
Reason for Leaving
Starting Final
Full-Time
Part-Time
(Zip)(State)(City)
(Street)
Work Performed
Telephone Number(s)
Dates Employed
Employer
From To
(Month/Year)
Position HeldAddress
Supervisor's Name
Hourly/Annual Salary
Reason for Leaving
Starting Final
Full-Time
Part-Time
Work Performed
Telephone Number(s)
Dates Employed
Employer
From To
(Month/Year)
Position HeldAddress
Supervisor's Name
Hourly/Annual Salary
Reason for Leaving
Starting Final
Full-Time
Part-Time
(Zip)(State)(City)
(Zip)(State)(City)
(Street)
(Street)
Work Performed
Telephone Number(s)
Dates Employed
Employer
From To
(Month/Year)
Position HeldAddress
Supervisor's Name
Hourly/Annual Salary
Reason for Leaving
Starting Final
Full-Time
Part-Time
(Zip)(State)(City)
(Street)
Work Performed
Telephone Number(s)
Dates Employed
Employer
From To
(Month/Year)
Position HeldAddress
Supervisor's Name
Hourly/Annual Salary
Reason for Leaving
Starting Final
Full-Time
Part-Time
(Zip)(State)(City)
(Street)
Skills/Organizations
List any special skills you possess that are relevant to this position; for example, software applications/programs (word processing, spreadsheets,
databases, etc.), computer or foreign languages, machines/equipment, etc.
List membership(s) in relevant trade and/or professional organizations.
Applicant's Statement
I authorize the release of any information from previous employers or character references.
I certify that if I am male, born after January 1, 1960, and required to register, I have registered for selective service. I understand
that I may be required to document registration.
If selected for an interview, signature will be requested prior to the interview.
I certify that this application and any other documentation accompanying this application are true and complete. I understand that
misrepresentation or omission of facts called for hereon or in my interview(s) will be sufficient cause for cancellation of
consideration for employment or dismissal from College service if I have been employed. I understand, also, that I am required to
abide by all rules and regulations of the employer, including participation in direct deposit of paychecks, presentment of social
security card, and participation in pre-employment drug screening. I further understand an annual report outlining crime statistics
for the Campus is available upon request from the Campus Human Resources Office.
Employment (Continued)
Date
Applicant Signature
Work Performed
Telephone Number(s)
Dates Employed
Employer
From To
(Month/Year)
Position HeldAddress
Supervisor's Name
Hourly/Annual Salary
Reason for Leaving
Starting Final
Full-Time
Part-Time
Work Performed
Telephone Number(s)
Dates Employed
Employer
From To
(Month/Year)
Position Held
Address
Supervisor's Name
Hourly/Annual Salary
Reason for Leaving
Starting Final
Full-Time
Part-Time
(City) (State) (Zip)
(Zip)(State)(City)
REQUIRED FORM
Please identify how you meet each required qualification listed on the Classification Specification.
Please use Additional Information page (included) if necessary.
Education/Training:
Experience:
Other Requirements (to include Selective and/or Knowledge, Skills, and Abilities):
DTCC Minimum Qualifications Summary
Name Position Date
Employment Data Record
An Equal Opportunity Employer
The purpose of this Employment Data Record is to comply with government record keeping, reporting, and other legal
requirements. Periodic reports are made to the government on the following information. The completion of this Data Record is
optional. If you choose to volunteer the requested information, please note that all Data Records are kept in a confidential file and
are not a part of your Application for Employment or personnel file. Please note: YOUR COOPERATION IS VOLUNTARY.
INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.
Voluntary Survey
1. Do you consider yourself to be Hispanic/Latino*?
2. In addition, please select one or more of the following racial
categories** to describe yourself:
Native Hawaiian or Other Pacific Islander
Black or African American White
AsianAmerican Indian or Alaskan Native
Yes
No
(City)
(First) (Last)
Name
Address (Number)
(Street)
(Zip)
(Middle)
Date
(State)
Date of Birth
Phone Number
Position Title applied for
Male Female
Gender
The Federal government has directed organizations to collect information for reporting purposes using a two-part question.
Please respond to Questions 1 and 2 below.
*Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
**American Indian or Alaskan Native: A person having origins in any of the original peoples of the North and South America (including Central
America), and who maintains tribal affiliation or community attachment.
Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example ,
Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Black or African American: A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
SSN
Additional Information
