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Application For Coaching Assistant - Track & Field

Please complete all items



E-mail and Phone Numbers (Include Area Code):


Mailing Address



Are you legally entitled to work in the U.S.?
Do you require sponsorship?
If Yes, please be advised that Chadron State College will not be able to offer sponsorship and cannot accept your application at this time.
Do you have a valid Driver's License?

Are you related to anyone employed by CSC?

Have you ever been employed by Chadron, Wayne, or Peru State College or the Nebraska State College System Office?

Are you 18 years of age or over?
Do you wish to claim Veteran's Preference?

Please note, you may be required to submit substantiating documentation if you are selected as a finalist.
Position Applying For: Coaching Assistant - Track & Field
Type of Position Desired

General Information
List three references other than relatives who have knowledge of your skills and character.




Reference's Address





Reference's Address





Reference's Address


Employment Record
Current or most recent position







May we contact your current employer?





Educational Background



School's Mailing Address


School's Mailing Address


School's Mailing Address


School's Mailing Address

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The following documents are required by Human Resources

Combined File Size cannot exceed 40MB in size

Please read the following carefully before signing this application:
I attest to the accuracy and truthfulness of the information provided, and I understand that falsification or omission of any information on this application could result in my disqualification from further consideration in the selection process, or if hired, termination of my employment. I understand that consideration for employment is conditioned upon the results of a background check, and I authorize the Board of Trustees of the Nebraska State Colleges, the College and its agents or assigns to investigate all statements made by me on this application, to conduct a thorough investigation of my background and activities, and I agree to cooperate in such investigation and to release the Board of Trustees and its agents and assigns from all liability or responsibility and of all persons and corporations requesting or supplying such information. I authorize the Board of Trustees of the Nebraska State Colleges, the College and its agents and assigns to contact my cited references and any developed uncited references to make inquiries concerning my current and past employment. This authorization will expire six months from the date it is signed. A facsimile copy or electronic version of this document shall be considered as effective and valid as the original.
Please acknowledge the acceptance and understanding of the above statement by typing your name or initials in the "Applicant Signature" field. This form will not be accepted unless this portion is completed.


Chadron State College is an equal opportunity institution. CSC does not discriminate against any student, employee or applicant on the basis of race, color, national origin, sex, disability, religion, or age in employment and education opportunities, including but not limited to admissions decisions. The College has designated an individual to coordinate the College’s non-discrimination efforts to comply with regulations implementing Title VI, VII, IX, and Section 504. Inquiries regarding non-discrimination policies and practices may be directed to:

Shelley Dunbar, Title VI, VII, IX Compliance Coordinator
Chadron State College, 1000 Main Street
Chadron, NE 69337
Phone 308.432.6224

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