The SC-1 form, a vital tool for faculty and academic-related position applicants at California State University, Long Beach (CSULB), serves multiple functions from capturing personal data to outlining professional experience, thereby helping unite qualified candidates with the appropriate departmental roles. This form not only gathers basic personal information, such as name, address, and social security number, but it also inquires about an applicant's legal ability to work in the United States, ensuring compliance with employment law from the outset. Applicants disclose any familial connections within the university, past employment dismissals, and convictions, ensuring transparency and integrity in the hiring process. A comprehensive section dedicated to educational background mandates listing the highest degree first, emphasizing the importance of academic qualifications. The employment record segment encourages a detailed account of both teaching and non-teaching professional experiences, further enriched by an area for publications, honors, awards, and relevant volunteer work. An affirmation of the truthfulness and accuracy of the provided information is required by the applicant's signature, underscoring the seriousness with which the information is to be regarded. Additionally, CSULB's commitment to non-discrimination and accommodation for applicants with disabilities is emphatically stated, reflecting broader institutional values of diversity, tolerance, civility, and respect. The inclusion of information regarding the university's annual crime report availability echoes CSULB's dedication to transparency and safety for its community members. Altogether, the SC-1 form is a comprehensive document that supports CSULB's efforts in aligning academic and professional expertise with its educational mission while upholding ethical and legal standards.
| Question | Answer |
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| Form Name | Sc 1 Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | sc1 form pdf, how to sc1 form, sc 1 form fillable, sc1 form |
CALIFORNIA STATE UNIVERSITY, LONG BEACH
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FOR FACULTY AND ACADEMIC- RELATED POSITIONS |
SC- 1 |
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STATEMENT OF PROFESSIONAL PREPARATION AND EXPERIENCE |
FORM |
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POSITION APPLYING FOR |
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DEPARTMENT NAME |
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P E R S O N A L D A T A
LAST NAME |
FIRST NAME |
MIDDLE NAME |
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ADDRESS |
STREET |
APARTMENT NUMBER |
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CITY |
STATE |
ZIP CODE |
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SOCIAL SECURITY NUMBER |
HOME/ WORK PHONE NUMBER |
E- MAIL |
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ALL OFFERS OF EMPLOYMENT ARE CONDITIONAL UPON SATISFACTORY PROOF OF AN APPLICANT’S IDENTITY AND LEGAL ABILITY TO WORK IN THE UNITED STATES AT THE TIME OF EMPLOYMENT.
ARE YOU CURRENTLY AUTHORIZED TO WORK IN THE U.S.? |
9 YES |
9 NO |
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DO YOU HAVE RELATIVES WORKING FOR THE UNIVERSITY? |
9 YES |
9 NO |
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IF YES, PLEASE GIVE THE FOLLOWING INFORMATION. |
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NAME |
RELATIONSHIP |
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DEPARTMENT |
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WERE YOU EVER DISCHARGED FROM ANY EMPLOYMENT? |
9 YES |
9 NO |
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IF YES, PLEASE EXPLAIIN FULLY BELOW. |
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CONVICTION RECORD
HAVE YOU EVER BEEN COVICTED OF ANY FELONY OFFENSE?9 YES9 NO
IF YES, PLEASE LIST THE CIRCUMSTANCES, PLACES AND DATES.
[DO NOT LIST ANY OFFENSE THAT OCCURRED PRIOR TO YOUR 18TH BIRTHDAY, WHICH WAS HANDLED OR SEALED BY A JUVENILE COURT.]
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ACADEMIC PERSONNEL
REVISED JUNE 14, 2002
EDUCATION - HIGHEST DEGREE MUST BE LISTED
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CITY & STATE LOCATION |
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YEARS ATTENDED |
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DEGREE, IF ANY, & |
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MO/ DAY/ YR |
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NAME OF INSTITUTION |
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DEGREE |
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[LIST FOREIGN COUNTRY] |
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FROM – TO |
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SUBJECT MAJOR |
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OBTAINED |
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EMPLOYMENT RECORD |
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EXPERIENCE IN TEACHING & OTHER EMPLOYMENT. LIST CURRENT POSITION FIRST. |
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POSITION/ TITLE |
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FULL TIME OR |
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EMPLOYER |
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CITY & STATE LOCATION |
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& / OR |
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PART TIME |
DATES OF EMPLOYMENT |
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ACADEMIC RANK |
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EMPLOYMENT |
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PUBLICATIONS, HONORS & AWARDS
OTHER RELEVANT EXPERIENCE [INCLUDE VOLUNTEER WORK]
ATTENTION! PLEASE READ CAREFULLY BEFORE SIGNING.
Your signat ure af f irm s that all inf orm ation on this applicat ion is true to the best of your knowledge.
I cert ify that the statem ents m ade by m e on t his application are t ruthful and accurat e, and in the event that any of the st atem ents are f alse, I understand t hat I will be subject to dism issal.
SIGNATURE |
DATE |
CALIFORNIA STATE UNIVERSITY, LONG BEACH does not discrim inat e on t he basis of disabilit y against ot herwise qualified disabled applicant s. CSULB will m ake reasonable accom m odat ion t o applicant s wit h ident ified disabilit ies. If you need accom m odat ion in t he pre- em ploym ent select ion process (applicat ions, t est s, int erviews, et c.), please cont act t he chair of t he depart m ent t o which you have applied . In addit ion t o m eet ing fully it s obligat ions of nondiscrim inat ion under federal and st at e law, CSULB is com m it t ed t o creat ing a com m unit y in which a diverse populat ion can live and work in an at m osphere of t olerance, civilit y, and respect for t he right s and sensibilit ies of each individual, wit hout regard t o econom ic st at us, et hnic background, polit ical views, sex ual orient at ion, or ot her personal charact erist ics or beliefs. Copies of t he Universit y's Annual Cam pus Crim e Report are available upon request . To request a copy, cont act t he Universit y Police Depart m ent at (562) 985 - 8535 or t hrough t heir web sit e ht t p:/ / www.upd .csulb .edu, or by writ ing t o: CSULB Universit y Police Dept . 1331 Palo Verde Ave., Long Beach, CA 90840, At t n: Crim e Prevent ion.
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