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Document
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Application for Employment

 

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POSITION APPLIED FOR

Position Title

 

Location

 

Vacancy #

 

 

PERSONAL INFORMATION

Name (Last, First, Middle Initial)

 

Address (Street, City, State, Zip Code)

 

Home Phone #

 

Cell Phone #

 

Work Phone #

 

E-mail Address

 

Name of someone who knows how to contact you if your address changes

 

Contact’s Phone #

 

Contact’s E-mail Address

 

How did you find out about this job opening?

q Web Page (identify) ______________________________            q Newspaper/Journal Ad (identify) __________________________

q Referral            q Job Service         q Other (Please Explain)

Are you authorized to work in the U.S.?  q Yes        q No

If employed, you must show documents that prove your identity and employment eligibility as required by the Immigration Reform and Control Act of 1986.

Are you in any way related to any employee of the University?        q Yes       q No  

If yes, indicate the individual’s name, relationship and department. 

Minimum Acceptable Salary?

 

Date Available for Employment?

 

How you been convicted of a crime in the past (7) years? 

If yes , Please explain_________________________________________________

 

_______________________________________________________

 

_______________________________________________________

 

 

Note: Conviction Will Not Be A Bar To Employment, Each Instance and Explanation will be Considered in Relation to The Position for Which Your Are Applying. 

 

Driver’ s License Number _____________________________

 

 

Do you have Reliable Transportation?   Yes____   No ____

 

 

Do you smoke?   Yes ___    No ____    Sometimes_____

 

 

EDUCATION – List most recent first (Use supplemental sheet if necessary)

Name of College or University

Advisor
Date Attended

From                    To

Type of Degree

Major / Hours
Year Earned

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROFESSIONAL & COMMUNITY INVOLVEMENT – List most relevant (Use supplemental sheet if necessary)

Name of Organization

Position or Type of Activity
Duration of Involvement

From                    To

Awards/ Recognition Received

Reason for Ending Involvement

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYMENT HISTORY – List all employment including military and volunteer service starting with the most current position held. Show employment history for at least 10 years or from the time you left school. Explain gaps in employment history. You may attach a resume, but you must complete the employment section. This information will be used in reference checks. Failure to answer all items in the following section may eliminate you from further consideration.

 

Dates Employed (month/year)

Position Title

     

From:       

To:       

Salary

 

Organization Name/Address

     

Start: $      

Final: $      

 Full-time            Part-time, hrs/wk      

May we contact for references
 Yes                     No

Supervisor's Name/Title/Phone:

     

Reason For Leaving:

     

Duties:       

Dates Employed (month/year)

Position Title

     

From:       

To:       

Salary

 

Organization Name/Address

     

Start: $      

Final: $      

 Full-time            Part-time, hrs/wk      

May we contact for references
 Yes                     No

Supervisor's Name/Title/Phone:

     

Reason For Leaving:

     

Duties:       

Dates Employed (month/year)

Position Title

     

From:      

To:       

Salary

 

Organization Name/Address

     

Start: $      

Final: $      

 Full-time            Part-time, hrs/wk      

May we contact for references
 Yes                     No

Supervisor's Name/Title/Phone:

     

Reason For Leaving:

     

Duties:       

Dates Employed (month/year)

Position Title

     

From:      

To:       

Salary

 

Organization Name/Address

     

Start: $