ࡱ> y{x` Mbjbj mhMLLL`8dDt`)rZZZZ: `((((((($*h_-.(]L?@??(ZZL?) ?jZ8Z( ?( :%,4p&Z E"j& @'|U)0)&R. .p&.Lp&< ~lU<<<(( j<<<)????``` $```$``` Position Applying For: FORMTEXT      Requisition #: FORMTEXT       Please mail to: (Name of department) Search Committee 1801 E. Cotati Avenue, Rohnert Park, CA 94928 PERSONAL DATAName:  FORMTEXT        FORMTEXT        FORMTEXT    Last Name First Name Middle InitialAddress:  FORMTEXT        FORMTEXT        FORMTEXT       Address City, State, Zip Code CountryHome Phone: ( FORMTEXT    )  FORMTEXT    - FORMTEXT      Cell Phone: ( FORMTEXT    )  FORMTEXT    - FORMTEXT      E-Mail:  FORMTEXT       WORK AUTHORIZATIONIf hired, you will be required to furnish proof that you are legally authorized to work in the U.S. Can you furnish such proof?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Please attach current curriculum vitae (if not previously submitted during a search) containing at least the following information: Education Colleges or Universities attended, their locations and dates of attendance Majors or fields of study, including undergraduate and graduate majors, degrees earned and areas of concentration NOTE: All degrees will be verified by notarized transcripts from the degree-granting institutions prior to employment Experience Beginning with the most recent activities, a chronological listing of teaching & related professional work experience, including the name, location and phone number of previous employers, dates of employment, title or academic rank, and reason for leaving. A specific listing of courses previously taught. Indicate whether permission is given to contact previous employers. Publications, honors, awards and memberships in professional organization. Any other qualifying experience, whether paid or voluntary or other information you wish to have considered. Include any another other employment experience you wish to have considered, including place of employment, position or title, full or part-time and inclusive dates of employment. The names, addresses, and telephone numbers of at least three people not related to you whom we may contact for an evaluation of your professional abilities. Other Pertinent InformationIf the duties of your position require you to drive a state vehicle on state business, will you be able to furnish a current, valid California Drivers License?  FORMCHECKBOX  Yes  FORMCHECKBOX  NoAs an adult, have you ever been convicted of a crime (except traffic violations other than felonies)?  FORMCHECKBOX  Yes  FORMCHECKBOX  No A conviction includes a plea, verdict or finding of guilt, regardless of whether a sentence was imposed by the court. You need not provide information about marijuana possession convictions for a violation of Health and Safety Code Section 11357(b) or (c), Section 11360(c), or Section 11364, 11365, or 11550 that occurred more than two years ago. (NOTE: A conviction will not necessarily disqualify an applicant from employment) If yes, explain:  FORMTEXT      Have you been arrested for any criminal offense for which you are out on bail, or on your own recognizance, pending trial?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Statement of AccuracyI certify that the answers I have given in the materials I have submitted in the application for this position are true and correct and that I have not knowingly withheld any facts or circumstances. 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The application materials include this document and any other materials submitted.  FORMTEXT       Signature Date Sonoma State Universitys annual security report includes statistics for the previous three years concerning reported crimes that occurred on campus, in certain off-campus buildings or property owned or controlled by Sonoma State University and on the public property within, or immediately adjacent to and accessible from the campus. The report also includes institutional policies concerning campus security, alcohol/drug use, crime prevention, reporting of crimes, sexual assault and other matters. 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