SCO Employment Application Question Title * 1. For what position are your applying OK Question Title * 2. Contact Information Name Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number OK Question Title * 3. Date available for work Date / Time Date OK Question Title * 4. Expected annual salary less benefits OK Question Title * 5. Are you eligible for employment in the US?(proof of citizenship or immigration status will be required) Yes No Other (please specify) OK Question Title * 6. High School Diploma Name of institution Special training if any OK Question Title * 7. College Degree information last three attended- enter institution name/Degree type/Field of Study/Special training or skill acquired/year graduated College1 College2 College3 Notes or comments OK Question Title * 8. List any professional certifications/License and expiration dates OK Question Title * 9. List any awards, honors, professional memberships: OK Question Title * 10. Employment History - Most recent first Company Name Dates of employment Address Title of your position Supervisors name and position Supervisors contact info: Phone/email May we contact this employer OK Question Title * 11. Brief job description OK Question Title * 12. Reason for leaving OK Question Title * 13. Employment History - next most recent Company Name Dates of employment Address Title of your position Supervisors name and position Supervisors contact info: Phone/email May we contact this employer OK Question Title * 14. Brief job description OK Question Title * 15. Reason for leaving OK Question Title * 16. Employment History - next most recent Company Name Dates of employment Address Title of your position Supervisors name and position Supervisors contact info: Phone/email May we contact this employer OK Question Title * 17. Brief job description OK Question Title * 18. Reason for leaving OK Question Title * 19. Please account for time gaps of three (3) months or more between jobs OK Question Title * 20. Professional references 1 Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK Question Title * 21. Professional references 2 Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK Question Title * 22. Professional references 3 Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK Question Title * 23. Specify the various types of office machines, computer equipment or any other equipment you can operate, that are applicable to the position for which you are applying. OK Question Title * 24. Specify the various types of software you can use. OK Question Title * 25. Have you ever been convicted of or pled guilty to anything other than minor traffic violations? If so explain. OK Question Title * 26. Enter you initials as your signature. Your signature signifies that you have read and understand the term and conditions located at the link below. OK Application terms and conditionsApplicants to Southern College of Optometry may access the Annual Security report posted on the College website: http://www.sco.edu/campus-safety. The report contains safety efforts and statistics for the campus. Applicants may also request a printed copy by contacting the Safety and Security Department at 901-722-3312 or email donhenson@sco.edu. OK DONE