(A separate application must be provided for each position in which you are interested.)
Position Applying for: Posting Number:
How did you learn of this position?
Date Available:
Newspaper Other
Please List:
APPLICATION FOR EMPLOYMENT
Date:
Please
p
rint clearl
y
in ink and com
p
lete all information re
q
uested
Name:
Last First M. I.
Street Address:
City: State: Zip:
Previous Address: (Complete only if at current address less than 2 years)
City: State: Zip
Home Phone #: ( ) Message Phone #: ( ) Preferred Contact #: ( )
POSITION DESIRED
PERSONAL INFORMATION
1. If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in the United States?
1. Yes No
2. Are you at least 18 years of age or older? If “no,” a work permit may be required. 2. Yes No
For reference purposes, have you worked or attended school under a former name?
If yes, please list former name(s):
3. Have you ever worked for The Claremont Colleges? If yes, which college? 3. Yes No
4. Are any relatives or members of your household currently employed at this institution? 4. Yes No
If yes, give full name and position.
5. Are you able to perform the essential functions of the position applied for, either with or without reasonable accommodation?
5.
Yes No
6.
Have you ever been discharged from any employment, asked to resign or advised that if you did not resign, your
employment would be terminated? If yes, please explain.
Yes No
We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the
purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal
access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the
application and/or interview process should contact the Human Resources Office.
Minimum Desired Pay:
CGU Website
CGU Job Posting
6.
EDUCATION AND TRAINING
Type of School Name and Location No. of Years Did You Major &
Completed Graduate? Degree
Yes No
Are you attending school now? Yes No Name/Course of Study:
SPECIAL SKILLS
Licenses/Certificates: Answer only if position applied for requires a driver’s license.
Do you have a valid driver’s license issued by the
State of California? Yes No
Keyboarding WPM: Computer Programs:
Special Equipment:
List Foreign Language(s) (optional):
Speak ____________ Read ____________ Write ____________ Interpret and/or translate _____________
____________ ____________ ____________ _____________
Do you have any other experience, training, qualifications or skills, which you feel, make you especially suited for the position
applied for?
Yes No If yes, please explain.
High School/
GED/CHSPE Yes No
College(s) or
University(ies)
Yes No
Business/Trade or
Technical School
Yes No
EMPLOYMENT HISTORY
For the last 10 years, starting with most recent, list each job held and account for all periods of unemployment.
Attach additional sheets if necessary. You must complete this section even if attaching a r´esume´.
EMPLOYER: May we contact this employer: Yes No
Address: Phone:
Supervisor’s Name: Phone:
Date Started: Date Left:
Title or Position:
Duties and Responsibilities:
Reason for Leaving:
Account for periods of unemployment between jobs:
EMPLOYER: May we contact this employer: Yes No
Address: Phone:
Supervisor’s Name: Phone:
Date Started: Date Left:
Title or Position:
Duties and Responsibilities:
Reason for Leaving:
Account for periods of unemployment between jobs:
EMPLOYER: May we contact this employer: Yes No
Address: Phone:
Supervisor’s Name: Phone:
Date Started: Date Left:
Title or Position:
Duties and Responsibilities:
Reason for Leaving:
Account for periods of unemployment between jobs:
EMPLOYMENT HISTORY
EMPLOYER: May we contact this employer: Yes No
Address: Phone:
Supervisor’s Name: Phone:
Date Started: Date Left:
Title or Position:
Duties and Responsibilities:
Reason for Leaving:
Account for periods of unemployment between jobs:
EMPLOYER: May we contact this employer: Yes No
Address: Phone:
Supervisor’s Name: Phone:
Date Started: Date Left:
Title or Position:
Duties and Responsibilities:
Reason for Leaving:
Account for periods of unemployment between jobs:
Important, please read carefully and sign.
I hereby certify that the information on this application and all other information otherwise provided are true and correct. I
understand that any misrepresentations or omissions will be sufficient cause for cancellation of this application or immediate
termination of employment if I am employed, whenever it may be discovered.
If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an
agreement or contract for employment. Accordingly, either I or the institution can terminate the relationship at will, with or without
cause, at any time. I further acknowledge that the only manner in which the “at will” nature of the employment relationship can be
altered is by means of a specific written agreement signed by me and the institution’s President or Chief Executive Officer.
I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.
Applicant’s Signature Date:
CERTIFICATION
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