Faculty Application Certification Form and Instructions

Human Resources

Congratulations on your invitation to campus for an interview. The Office of Human Resources is happy to answer any questions you may have about benefits or employment at Lewis & Clark College. Please call us at (503) 768-6235.

At this point in the interview process, the College asks for your assistance in two ways.

Please complete following application certification. You will get an acknowledgement email upon completion.
As the College conducts criminal and other background checks for the finalist or finalists for all positions, please print the authorization form (PDF), complete it, mail or fax it to Human Resources (information is on the bottom of the form). At the appropriate time, InfoLink will call or email you for your birth year. InfoLink is our third party vendor that will conduct the background checks. You may also wish to review A Summary of Your Rights Under the Fair Credit Reporting Act (PDF).

Lewis & Clark College adheres to a nondiscriminatory policy with respect to employment, enrollment, and program. The College does not discriminate on the basis of race, color, creed, religion, sex, national origin, age, handicap or disability, sexual orientation, or marital status and has a firm commitment to promote the letter and spirit of all equal opportunity and civil rights laws. The College affirmatively seeks to build a diverse community of highly qualified faculty and staff.

Please use the "tab" key to jump between fields on this form. Pressing "enter" may cause the form to submit before you are finished.

First Name	Middle	Last Name

Position Applied For

Department

How did you learn of this position?

Local Newspaper
National Publication
Friend/Relative
L&C Web site
Other Web site
Other

Please specify:

Street Address

City/State/Zip Code

Home Phone

Message Phone

E-mail Address

Availability and Criminal History

Are you legally eligible for employment in this country? (Proof of citizenship or immigration status will be required upon employment.)

Yes No

Under your name or another name, have you ever been convicted (or pleaded guilty or no contest) of a felony or misdemeanor which resulted in prison and/or jail and for which you were released or paroled? (Do not identify convictions for which the criminal record has been expunged or sealed by the court; or, misdemeanor conviction for which any probation has been completed and the case dismissed by the court. Please note that no applicant will be denied employment solely on the ground that they have been charged, committed, or convicted of a criminal offense or, solely on an affirmative answer. The nature, date, surrounding circumstances, and relevance of the offense to the position applied will be considered.

Yes No

If yes, please explain:

Submit Application

Please read the following carefully before completing your application:

Lewis & Clark College adheres to a nondiscriminatory policy with respect to employment, enrollment, and program. The College does not discriminate on the basis of race, color, creed, religion, sex, national origin, age, handicap or disability, sexual orientation, or marital status and has a firm commitment to promote the letter and spirit of all equal opportunity and civil rights laws. Interviews are given on a competitive basis, using job-related factors, after a written application has been received and reviewed. Because of the large number of applications received, not everyone who applies for a vacant position will be interviewed.

I certify that I have answered truthfully and have not knowingly withheld any information relative to my application. I understand that any misrepresentation or material omission on this application will result in my being eliminated from further consideration. I further understand that, if accepted for employment, any misrepresentation or material omission that becomes known to Lewis & Clark College will result in immediate termination of my employment.

I authorize the employers and supervisors listed in this application to give Lewis & Clark College representatives any and all information regarding me and my previous employment. I release Lewis & Clark College and all previous employers and supervisors from liability for any damages that may result from furnishing information to Lewis & Clark College.

In consideration of my employment, I agree to conform to the instructions, rules, and policies of Lewis & Clark College. My employment and compensation can be terminated at any time, with or without cause and with or without notice, at the option of either the College or myself. I understand that no representative of the College has authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.

Information about the annual campus security report, the enforcement authority of Campus Safety, campus crime reporting, and three-year crime statistics may be requested from the Office of Campus Safety at 503-768-7855.

Yes, I have read and agree to the above statement.

* Before submitting, please consider filling out the form below. It's entirely optional, but will help us ensure equal opportunity.

Equal Employment Opportunity

Lewis & Clark College is attempting to monitor recruitment and selection programs in order to assure equal opportunity. We would appreciate your cooperation in providing the following information. Your cooperation is voluntary. This information is for statistical use only, and will be kept confidential and separate from your application for employment.

Male Female

White Black Hispanic
Asian/Pacific Islander Alaskan Native/American Indian

Vietnam Era Veteran Disabled Veteran Handicapped Individual

Contact Us

The Office of Human Resources is located in South Chapel Annex.

email hr@lclark.edu

voice 503-768-6235
fax 503-768-6233

Director Isaac Dixon

Office of Human Resources
0615 S.W. Palatine Hill Road, MSC 72
Portland, Oregon 97219