Workforce Temporary Instructor and Volunteer Registration

Do you have a valid Texas Drivers License? *

Yes

No

Do you have a Texas CDL License?*

Yes

No

How many years of teaching experience do you have?*

0-1 years

1-2 years

2-3 years

4-5 years

5 or more years

How many years of experience do you have in this type of position?*

0-1 years

1-3 years

3-5 years

5-7 years

7+ years

Various Federal and State agencies require employers to maintain information on applicants pertaining to factors such as race, sex, and type of position for which an individual applies. The information requested on this sheet is for compliance with certain record keeping requirements. Lamar State College - Port Arthur believes all persons are entitled to equal employment opportunities and does not discriminate against employees or applicants for employment because of race, color, sex, religion, national origin, disability, veteran status, age, marital status or any other protected group status.

I acknowledge being notified that, with exceptions, I have the right to be informed of and to receive, review, and, if necessary, correct the information that Lamar State College - Port Arthur collects on me.

Voluntary Demographics

Sex

Female

Male

Race/Ethnic Data

American Indian / Alaskan Native

Asian or Pacific Islander

Black (Non-Hispanic)

Hispanic

White (Non-Hispanic)

Veteran Status

Vietnam Era Veteran

Disabled Vietnam Era Veteran

Veteran - Other

Disabled Veteran - Other

Surviving Spouse

Orphan of Veteran

Are you a retiree from a Texas state agency or university, community college, or school district eligible for ERS/TRS/ORP benefits?

Yes

No

Retirement Plan

ERS

TRS

ORP

Will you be simultaneously employed at LSC-PA and another Texas state agency or university, community college, or school district?

Yes

No

Are you eligible to participate in the Uniform Group Insurance Program?

Yes

No

Are you contributing to Teacher Retirement System (TRS)?

Yes

No

Copies of official transcripts from all colleges/universities attended must accompany this form. Original transcripts are required upon hire.

All men age 18 to 25 must be registered with the Selective Service System in order to be hired for any position with the State of Texas. Click Here to download the Selective Service Registration Form. Please attach a copy of the registration card to this application.