Please select the highest grade you have completed:
Please click and type this information in the boxes below.
Optional Demographic Information
Do you have any special needs that require accomodation?
Does your family receive public assistance (e.g. TANF, Food Stamps, Medical Card)?
Date Format: MM slash DD slash YYYY
Certification of Application
The statements that I have made in this application are true and complete to the best of my knowledge and I understand that any alteration or concealment of a material fact will result in my disqualification before appointment or dismissal after appointment. I understand that Southwestern Illinois College is a drug-free workplace and that I must be drug-free at the time of appointment and throughout my term of service. I will be required to submit to a criminal background check. I hereby authorize Southwestern Illinois College or its representative to investigate my background, including but not limited to past employment, military and police records. My permission is hereby given to any and all persons, agencies, corporations, firms or associations to release any and all such information, records or other documents to Southwestern Illinois College or its representative for its inspection and copying. A copy hereof shall be considered equally authentic as the original.