Verification-Occupational-Experience

Verification-Occupational-Experience



Microsoft Word – VOE revised 101315.doc





VERIFICATION OF OCCUPATIONAL EXPERIENCE (Non-Teaching)
The Wisconsin Technical College System (WTCS) requires that all educational personnel be hired on the basis of
their education and occupational experience. Please verify the following individual’s employment as authorized
below.

AUTHORIZATION: To be completed by Applicant/Employee and forwarded to Employer.
Print Name: _____________________________

Social Security Number: _________________________

Street Address: ______________________________

City/State/Zip: _________________________________

I authorize my present/former employer to furnish Western Technical College with the information requested below.

Name of Present/Former Employer: _____________________________________________________________
Street Address: __________________________________ City/State/Zip: _______________________________
Signature: ____________________________________________________

Date: _____________________

EMPLOYMENT RECORD: To be completed by Employer and returned to Western Technical College.
The above named individual is/was employed by our organization:
From: (MM/DD/YYYY) _______________________
The employee is/was employed

To: (MM/DD/YYYY)

Full-Time:

______________________

The employee is/was employed

Part-Time:

For ________ hours per week for _________ weeks.

For _______ hours per week for _________ weeks.

Total number of Full-Time hours employed to date:_______

Total number of Part-Time hours employed to date:______

Job Title or Classification:
List Primary Job Duties: (Attach position description if available)

Percentage of Time:

_____________________________________________________________

_________________

_____________________________________________________________

_________________

_____________________________________________________________

_________________

VERIFICATION: Employer verifies information and returns form to Western Technical College.
Company Name: _____________________________________

Return Completed Form to:

Street Address: ______________________________________

Western Technical College
Attn: Human Resources
th
400 7 Street North
La Crosse, WI 54601
Fax: 608-789-4708

City/State/Zip: _______________________________________
Signature: __________________________________________
Title: ______________________________________________
Date: ______________________________________________

Attention:
Sarah Jackson
608-789-6253
jacksons@westerntc.edu
10/15