Fillable Application-for-Employment-12-12-2017 APPLICATION FOR EMPLOYEMENT

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Application-for-Employment-12-12-2017 APPLICATION FOR EMPLOYEMENT

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Revised 12/12/2017
APPLICATION FOR EMPLOYMENT
WITH
WILKES UNIVERSITY
(Application Limited to the Opening Specified)
NAME:
POSITION:
DATE:
E
MAIL Address: ______________________________________________
Wilkes University is constantly seeking to become a more diverse community and to enhance its
capacity to value and capitalize on the cultural richness that diversity brings. The University strongly
encourages applications from persons with diverse backgrounds.
Revised 12/12/2017
A
PPLICATION FOR EMPLOYMENT
Date: Position Applied For:
How did you hear about this opening?
Date Available for Work: EMAIL Address:_______________________________
I
NSTRUCTIONS: Please read carefully. Every item on this form must be answered to the best of your ability and
knowledge. Please type or print and use a pen. Your qualifications will be carefully reviewed, and you will be given
thorough consideration for the vacancy/position for which you have applied. Upon employment, this application will
become part of your permanent record with us. Keep this in mind as you complete it. Special Note: You are not
required to supply any information that is prohibited by Federal, State or Local law.
PERSO
NAL
:
Name Telephone No.
First M.I. Last
Street Box City St Zip
Previous Address Social Security No.
Other names you have used: _____________________________ Are you 18 year of age or older? Yes No
Are you legally entitled to work in the United States? Yes No
(You will be required to provide proof of identity and eligibility to work in the U.S. if hired)
If you are a resident of the City of Philadelphia, do not answer the following question. Proceed to EDUCATION
.
H
ave you ever been convicted of or pleaded guilty or Nolo Contendre (no contest or an Alford plea) to any felony?
Yes No
T
he fact you have been convicted of a crime will not automatically disqualify you from further consideration for
employment.) If “yes” please describe in detail and attach to application.
E
DUCATION
:
H
igh School (Name)______________________________________________________________
Address
T
elephone No. ___________________________________
Did you graduate? If no, last grade completed G.E.D. Obtained?
C
ollege: _____________________________________________________________________________
Address:
Telephone No.
College:
Revised 12/12/2017
Address: ________________________________________________________________
Telephone No.
Did you graduate? If no, number of hours completed
Grade Point Average Degree
Major Minor
Other Education
Certifications
Awards, Honors, Leadership Roles
Foreign Languages
M
ILITARY
: not applicable
List service in U.S. Military: From to Branch
Rank at Discharge
Military experience that may be applicable
G
ENERAL EMPLOYMENT INFORMATION
:
1. L
ist all specialized skills with which you have experience and training. (Example: PC/MAC applications)
:
2. Were you previously employed by us?
If yes, when? to
** If you are a resident of California, do not provide “Present Salary”. Proceed to “Salary Expected”.
3. Present Salary: hr/week/year.
Salary Expected:
hr/week/year.
Number of hours available per week?
No preference.
4. T
ype of Employment sought: regular full time regular part time
temporary seasonal
5. W
hich of these times are you available?
Days Yes No
N
ights Yes No
W
eekends Yes No
Holidays Yes No
6. List here names of relatives currently in our employ:
Revised 12/12/2017
7. In case of emergency, notify
Telephone Number
8. Can
you travel if a job requires it? Yes No
EXPERIENCE: PLEASE PROVIDE ALL INFORMATION AS REQUESTED.
Lis
t below all present and past employment beginning with your most recent employer. Please attach a separate sheet of
paper if you have additional prior employers.
**Residents of the state of California are not required to provide salary information.
1. Employer
Address Last Salary per hour or week
Kind of business Supervisor
Job Title Tele. No.
Reason for Leaving
Quit Discharge Retired Layoff Other
Dates Employed
t
o
2. Employer
Address Last Salary per hour or week
Kind of business Supervisor
Job Title Tele. No.
Reason for Leaving Quit Discharge Retired Layoff Other
Dates Employed
to
3. Employer
Address Last Salary per hour or week
Kind of business Supervisor
Job Title Tele. No.
Reason for Leaving Quit Discharge Retired Layoff Other
Dates Employed
to
4. Employer
Address Last Salary per hour or week
Kind of business Supervisor
Job Title Tele. No.
Reason for Leaving Quit Discharge Retired Layoff Other
Dates Employed
to
May we contact your current employer? o Yes o No
ACTIVITIES:
Pl
ease list any information which you feel may be helpful in considering your application. For example: significant work
accomplishments, special training, specific interests, etc.
Ple
ase list affiliations with professional, civic organizations which you consider relevant to your ability to perform the job
for which you are applying.
Revised 12/12/2017
CURRENT/PRIOR CONTRACTUAL OBLIGATIONS:
Do you have any contractual obligations relating to a prior employer or client, such as a Confidentiality and/or Non-
Compete Agreement? Yes No If so, please list the agreements, dates and employers/clients involved.
EMPLOYMENT REFERENCE:
Pl
ease list below three references who can attest to your skills, knowledge and experience, that will contribute to your
success in the position for which you are applying.
NAME
ADDRESS
TELEPHONE
OCCUPATION
NAME
ADDRESS
TELEPHONE
OCCUPATION
NAME
ADDRESS
TELEPHONE
OCCUPATION
Revised 12/12/2017
APPLICATION LIMITED TO OPENING SPECIFIED
P
LEASE READ CAREFULLY BEFORE SIGNING
I
hereby affirm that my answers to the foregoing questions are true and correct. I authorize Wilkes University to conduct
whatever investigation it deems necessary to confirm the answers submitted on this application. If the investigation
concludes that I provided any untrue information, this will serve as sufficient grounds to immediately terminate the
application process, or immediately terminate my employment regardless of when the discovery occurs.
I
understand and agree that my employment is “at will” for no definite period and may, regardless of the period of payment
and wages or salary, be terminated at any time for any reason without any previous notice. I further understand that no
University official has made any promises to the contrary or guaranteed me employment for any specified period of time,
or has the authority to make such promise/guarantee, and that no employee handbook or policy may be construed to the
contrary or interpreted as a contract or guarantee of employment.
I
also authorize any of my former employers to furnish Wilkes University with their record of my services, my reason for
leaving their employ, and any other information they may have concerning me. I hereby release any of my former
employers from any all liability for any damages in furnishing said record.
I
agree that if I am employed by Wilkes University, a full transcript of my records as an employee, including reason for
termination, may be given to a prospective future employer on its request, and do hereby release Wilkes University from
any and all liability or damages whatsoever in furnishing such information.
I agree to abide by the rules and policies of Wilkes University.
U
pon separation of employment, I authorize Wilkes University to withhold from my final paycheck, vacation and expense
checks any, and all monies owed to Wilkes University by me at the time of my termination.
T
he use of this application form does not indicate that there are any positions available, and in no way obligates Wilkes
University.
I agree that any claim or lawsuit relating to this application, my service or employment with Wilkes University or
its affiliates, whether relating to contracts or federal or state statutory claims, must be filed no more than six (6)
months after the date of the employment action that is the subject of the claim or lawsuit unless filed under a
federal or state statute with a shorter statute of limitations. I specifically waive any federal and state statutes of
limitations to the contrary.
Date: Signature:
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Application-for-Employment-12-12-2017 APPLICATION FOR EMPLOYEMENT

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Completed 4 January 2020

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