Credentialing Process Outline
Attached are the documents that will need to be completed. The individual will need to complete all documents and obtain
all required signatures. Upon completion, he/she will need to mail and/or hand carry (preferred) the documents to
Appropriate Dean for processing. The transcript(s) must be an “official” transcript and must be sent to the EPCC
Personnel Department (a transcript request form is attached for your convenience). The Dean contacts the applicant to
schedule a meeting. The individual may also contact the Dean to schedule this meeting. A separate meeting is then held
between the Dean and the Vice President of Instruction for final review and final credentialing approval. The Dean
notifies the applicant of their status. Deans may require an endorsement from the high school/district stating employment.
A general letter of interest must also be submitted. The letter should address why the individual is interested in teaching
dual credit course(s).
Along with these documents, the individual will need to go on line complete, print out and sign an EPCC Employment
Application. Go to www.epcc.edu "Online Resources > Employment Opportunities > Personnel Home > Employment
Opportunities EPCCafe-Application for Employment > New Users > Create Application"
Please refer to the following link for additional information on teaching requirements:
http://www.epcc.edu/EmploymentOpportunities/Documents/academic_requirements.pdf
To summarize, the following documents are required:
1. Application for Employment (must print and sign the online application)
2. Letter of Interest
3. Written Proficiency Form (will be provided to you when you meet with the Dean and Discipline Coordinator)
4. Authorization-Release of Information
5. Biographical Data Form
(The Biographical Data Form will need to be attached to the Dual Credit Faculty Non-Employee Statement of Release form)
6. Dual Credit Faculty Non-Employee Statement of Release. Must include DC subject to be taught (EPCC
course(s) name and number)
7. Work Experience Verification Form (Will be provided by the Dean; This is required for Occupational Education
courses/requires former employer’s signature)
8. Official Transcript (must be mailed to Personnel from institution to institution to be considered. “Official”):
El Paso Community College
Personnel Department
ATTN: Lucy Rosas
P.O. Box 20500
El Paso, TX 79998
Note: Transcripts issued in a language other than English must be accompanied by a full translation “word by word”
by an acceptable translator. Additionally, each foreign transcript must be evaluated for equivalency to United States
accredited course work by an acceptable agency such as those agencies certified by the National Association of
Credentialed Evaluation Services “NACES” or accredited by the Southern Association of Colleges and Schools “SACS”.
Please allow 3-6 weeks for review/processing.
Revised 9/12
Personnel Services Department
AUTHORIZATION FOR RELEASE OF INFORMATION
Carefully read this authorization to release information about you, then sign and date it in ink.
I authorize any officer or administrative representative of EL PASO COMMUNITY COLLEGE
(EPCC) to obtain any information relating to my employment or volunteer service from any of my past or
present employers and personal references. This information may include dates of employment,
volunteer services, position titles, salary, job description, job function and level of job responsibilities.
I understand that the information released to EL PASO COMMUNITY COLLEGE is for official use
solely for the purpose of my employment with EPCC. It may be redisclosed only as authorized by law.
Copies of this authorization that show my signature are valid as the original release signed by me. This
authorization is valid for one (1) year from the date signed or upon termination of my employment with
EL PASO COMMUNITY COLLEGE, whichever is sooner.
Signature (Sign in ink)
Full Name (Type or Print Legibly)
Other Names Used
Current Address (Street and City)
Ls\fac cred\Authorization for release of info 10 31 03
Date Signed
Social Security Number
State
ZIP Code
Home Telephone Number
(Include Area Code)
RESET FORM
DUAL CREDIT FACULTY NON-EMPLOYEE
STATEMENT OF RELEASE
PRINT FORM
___________________
Social Security Number
Name: ____________________________________________________________________________________
Last
First
Middle Name
Address: __________________________________________________________________________________
Street Address
City
State
Zip Code
Telephone: ________________________________________________________________________________
Employed with ______________________________________________________Independent School District
Employed at: ______________________________________________________________________________
Name of High School
Dual Credit Subject Taught: ____________________________________________________________
I, __________________________________________________, fully understand that as a Dual Credit Faculty
Printed Name
at El Paso Community College, I will not be entitled to receive any remuneration from the College; however, I
may be reimbursed expenses incurred on behalf of the College. Further, I accept complete responsibility for
any medical fees that I might incur as a result of injury to me during this volunteer service and fully release El
Paso Community College from any liability for such injury. I understand that I am not an employee of the
College and have no property interest in employment with the College. During this period of volunteer service
I understand that I will be required to abide by the policies and procedures of the College.
___________________________________________
_____________________________________________
Signature
Date
Supervisor’s Certification
Credentialed: Yes
No
___________________________________________
_____________________________________________
Signature of Instructional Supervisor
Date
___________________________________________
_____________________________________________
Printed Name
Campus
Personnel Services Department
__________________________________________
___________________________________________
Pay Systems Authorization
Date
PF 800-127
*Biographical Data Form must be attached to this form.
(Rev 06/10)
RESET FORM
PRINT FORM
BIOGRAPHICAL DATA FORM ______‐______‐______ Please Select One: New Hire (Never worked for EPCC before) Social Security Number/ID# Rehire Name: ____________________________________________________________________________________________ Last First Middle Name Is this a name change? Yes No Prior Name: _____________________________________________________ Home Address: ______________________________________________ Home Phone Number: ( ) ______‐_______ Street Address/City/State/Zip Code Gender: Male Female Marital Status: Married Single Date of Birth: _____________________ Emergency Contact Name: _________________________________________ Phone Number: ( ) ______‐_______ Relationship: __________________ Emergency Contact Address: __________________________________________ Street Address/City/State/Zip Code NEW ETHNICITY Non Hispanic or Latino Hispanic or Latino U. S. VETERAN STATUS None Other Protected Veteran Only (A person of Cuban, Mexican, Puerto Rican, South or Central Vietnam Veteran Only American or other Spanish culture or origin) Both Vietnam/Other Eligible Veteran HIGHEST EDUCATIONAL LEVEL/NAME OF INSTITUTION EEO INFORMATION (Select as many as apply, with which you mostly closely identify) 1 Doctorate 2 Masters Degree 1 White 3 Bachelors Degree 4 Associates Degree 2 Black 5 Certificate or Less 6 No Degree 4 Asian 7 High School/GED 4p Pacific Islander Name of Institution: __________________________________ 5 American Indian/Alaskan Native ____________________________________________________ TEXAS GOVERNMENT CODE SECTION 552.024/PUBLIC ACCESS OPTION FORM The Public Information Act allows employees, public officials and former employees and officials to elect whether to keep certain information about them confidential. Unless you choose to keep it confidential, the following information about you may be subject to public release if requested under the Texas Public Information Act. Therefore, please indicate whether you wish to allow public release of the following information. Yes No Yes No Home Address Social Security Number Home Telephone Number Information that reveals whether you have family members 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 El Paso Community College collects on me. _____________________________________________________ ___________________ Employee’s Signature Date
The El Paso County Community College District is an equal opportunity employer. The information requested is for reporting to governmental agencies, accrediting associations and other college related purposes, for benefits enrollment and internal statistical reporting. Revised 6/10/10 To:
Registrar
From:
Date:
Subject:
Request for Official Transcripts
Please send an Official Transcript of my academic course work to:
El Paso Community College
Personnel Department
ATTN: Lucy Rosas
P.O. Box 20500
El Paso, TX 79998
El Paso Community College
Personnel Department
ATTN: Lucy Rosas
9050 Viscount
El Paso, Texas 79925
If mailing via “express” mail, please use street address
Please return this form with the transcript. Thank you for your prompt attention.
______________________________
Signature
______________________________
Name Used During Attendance
______________________________
Printed Name
______________________________
Graduation Date/ Date Attended
______________________________
S.S. Number/ Student ID Number
______________________________
Present Street Address
______________________________
Date of Birth
______________________________
City, State, Zip Code
*A transcript is not considered OFFICIAL unless it transmitted directly from the issuing school
to the Personnel Services Department. Transcripts issued to student are not considered official.
Requested by: ___________________________
Name
El Paso Community College
Dual Credit Program
Credentialing Checklist
Letter of Interest
Employment Application (must print and sign the online application)
Resume (Optional)
X
Written Language Proficiency (provided by the Dean)
Authorization for Release of Information
Biographical Data Form
Dual Credit Faculty Non-Employee Statement of Release Form
Must include DC subject to be taught (EPCC course name and number)
Transcripts
(must be mailed to Personnel Attn: Lucy Rosas from institution to institution to be
considered “Official”)
X
Work Experience Form (provided by the Dean)
(Required for Occupational Education courses/requires former employer’s signature)
5/12