Qualifications Briefly describe how you are qualified for this position by
virtue of your interests, aptitudes, education and
experience. Where applicable to this position, include: California Drivers License, workshops, night school classes, seminars
and similar training activities attended. List specialized skills and abilities including language skills, specialized equipment.
(Attach additional page(s) it needed).
Computer Platforms/Programs:
Other equipment you operate:
Licenses or Certificates:
Please Read Carefully, and Sign Below
Can you, after employment, submit
verification of your legal right to
work in the United States?
Yes No
Are you under 18 years of age?
Yes No
Are You Presently Employed?
Yes No
If you are under 18 years of age, can you at the time of
employment submit a work permit?
Yes No
May We Contact Your
Present Employer?
Yes No
May we contact your
Former Employers?
Yes No
I hereby certify th
at I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by
me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I
understand that any omission or misstatement of material fact on this application or on any document used to secure employment, shall be grounds for
rejection
of
this
application
or
for
immediate
discharge
if
I
am
employed,
regardless
of
the
time
elapsed
before
discovery.
I hereby authorize the CSU, Bakersfield Auxiliary for Sponsored Programs Administration to thoroughly investigate my re
ferences, work record, education and
other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the CSU, Bakersfield Auxiliary for
Sponsored Programs Administration any and all letters, reports and other information related to my work record, without giving me prior notice of such disclosure.
In addition, I hereby release the CSU, Bakersfield Auxiliary for Sponsored Programs Administration, my former employers and all other persons, corporation,
partnerships
and
associations
from
any
and
all
claims,
demands
or
liabilities
arising
out
of,
or
in
any
way
related
to,
such
investigation
or
disclosure.
I understand that nothing contained in the application, or conveyed during the interview which may be granted, or during my employment, if hired, is intended
to create an employment contract between me and the CSU, Bakersfield Auxiliary for Sponsored Programs Administration. In addition, I understand and agree
that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of
either myself or the CSU, Bakersfield Auxiliary for Sponsored Programs Administration, and that no promises or representations contrary to the foregoing are
binding on the CSU, Bakersfield Auxiliary for Sponsored Programs Administration unless made in writing and signed by me and the CSU, Bakersfield Auxiliary
for
Sponsored
Programs
Administration
designated
representative.
Applicant Signature Date
A N A F F I R M A T I V E A C T I O N / E Q U A L O P P O R T U N I T Y E M P L O Y E R
Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the
presence of non-job-related medical condition or disabilities. It is the CSU, Bakersfield Auxiliary for Sponsored Program's policy to hire only United
States citizens and aliens lawfully authorized to work in the United States. All new employees must provide proof of identity and authorization to
work. Prospective applicants with a disability may request and receive reasonable accommodation during the application and selection process.
CSUB's annual crime report includes statistics for the previous three years concerning reported crimes that occurred on campus, in certain off-campus centers, such as our Antelope
Valley Satellite Campus and on property within, or immediately adjacent to and accessible from CSUB. The report also includes policies concerning security on campus, such as alcohol
and drug use, crime prevention, reporting crimes, sexual assault and other subjects. Additionally, a daily log of offenses is maintained and can be reviewed at the front desk of the
Department of Public Safety. You can obtain a copy of the annual report by contacting the Department of Public Safety/University Police at 661-654-2111 or by logging on to the
Department of Public Safety website at https://www.csub.edu/compliance/clery/index.html
10/2018
