Part-Time Instructor Interest Form


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Part-Time Instructor Interest Form

Directions: Please complete and click on SUBMIT

Important: Completion of this form does not substitute for completion of the Davidson County Community College Application for Employment form. Completing and submitting this Part-Time Instructor Interest Form will help us know what subjects you are interested in teaching. We will contact you for follow-up if it is determined that your teaching goals match the College’s needs. The information collected on this form will be kept confidential and used only to identify and follow up on your interest in teaching classes for DCCC in Continuing Education or College and Career Readiness.

All contact fields are required

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone Number (Day): (Example: 3361239999)

Phone Number (Evening): (Example: 3361239999)

Phone Number (cell): (Example: 3361239999)

E-mail Address:

List all Degrees, Certifications, Licensure, or subject matter expertise/experience you have:

In what areas are you interested in teaching?

	Health Care		Public Safety
	Computer Related		Building/Construction Trades
	College and Career Readiness		Other:

PERSONAL INTEREST/LEISURE COURSES YOU COULD TEACH: (examples: pottery, dancing, photography, selling a home, etc.)

Are you fluent in any foreign languages? yes no

Indicate languages:

In which location are you interested in teaching?
Davidson County Davie County Either location

Have you ever taken and/or taught an online course?
no

yes

If yes, please list courses:

Have you ever taught a classroom-based course?
no

yes

If yes, please list courses:

When are you available to teach? (check all that apply)
daytime evening weekends