Employment Application - South Carolina Department Of Corrections Page 3

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SOUTH CAROLINA DEPARTMENT OF CORRECTIONS
EMPLOYMENT APPLICATION
OFFICE USE ONLY
Return Completed Application To: Recruiting and Employment Services
App. Keyed:
(PRINT CLEARLY IN INK)
4502 Broad River Road
Initials
Columbia, SC 29210
DATE:
Position(s) applying for:
NCIC:
Job Title
SCDC Position #
Job Title
SCDC Position #
(
) DL:
VISITATION:
EQUAL OPPORTUNITY
EMPLOYER
Social Security #:
Name:
Last
First
Middle (full)
Maiden Name:
Email:
Mailing Address:
County:
City:
State:
Zip Code:
Home #:
Mobile #:
Work #:
Area Code + Number
Area Code + Number
Area Code + Number
Height:
Weight:
Do you possess a valid driver's license?
Yes
No
If yes, State Issued:
Drivers License #:
Expiration Date:
Class: A
B
C
D
E
M
G
Are you a U.S. Citizen?
Yes
No
If no, type of Visa:
and Number
NOTE: Correctional Officer position requires U.S. Citizenship and a Valid Driver’s License.
A. Are you willing to work in an institution?
Yes
No
B. Are you interested in temporary employment?
Yes
No
C. Can you work all days of the week?
Yes
No
D. Check the shift(s) you can work
First Shift
Second Shift
Third Shift
All Shifts
12 midnight-8am
8am-4pm
4pm-12 midnight
NOTE: Correctional Officers must be willing to work any 12 hour shift
Check County of Preference
Location of existing or proposed facilities
02 Aiken
14 Clarendon
23 Greenville
29 Lancaster
40 Richland
03 Allendale
18 Dorchester
24 Greenwood
31 Lee
42 Spartanburg
08 Berkeley
19 Edgefield
27 Jasper
33 McCormick
43 Sumter
10 Charleston
21 Florence
28 Kershaw
35 Marlboro
46 York
(Veterans must include copy(s) of DD-214 indicating all military service)
MILITARY SERVICE
Branch of Service:
Date of Entry:
Discharge Date:
Rank:
Type of Discharge: Honorable
Under Honorable conditions
Other
If other than honorable, explain (will not necessarily disqualify):
National Guard/Active Reserve: Are you a member?
Yes
No
Give specifics. Unit:
Check the source which led you to apply at the South Carolina Department of Corrections.
01
College Recruitment
10
Newspaper Ad
19
RIF - Rehire
02
State Job Service
11
Radio Ad
20
Voluntary Transfer
03
Employment Agency
12
Television Ad
21
Involuntary Transfer
04
Employee
13
Trade Journal Ad
22
Military Referral Service
05
Div. of Human Resource Mgmt
14
Field Recruiting
23
SCDC Website
06
Unsolicited Application
15
Unknown
24
Private Employment/Agency
07
Return from Leave
16
Referred from Voc. Rehab.
25
Internet
08
Return from Military
17
Transfer from another State Agency 26
Job/Career Fair
09
Rehire, Not from Leave
18
Elected or Appointed
Page 1

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